| NPI | 1558359190 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN KWON Owner 617-754-6486 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: MA 216761) |
| Enumeration Date | 2005-10-07 |
| Last Update Date | 2014-10-14 |