| NPI | 1558791475 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIN KOTWICKI Practice Administrator 781-895-7903 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0000X |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine |
| 2084N0400X Psychiatry & Neurology, Neurology | |
| 2084P2900X Psychiatry & Neurology, Pain Medicine | |
| Enumeration Date | 2013-11-13 |
| Last Update Date | 2024-04-15 |