| NPI | 1578078275 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEONID GORDIN Owner 617-661-6225 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2083T0002X Preventive Medicine Medical Toxicology |
| Additional Taxonomies | 133N00000X Nutritionist |
| 133NN1002X Nutritionist Nutrition, Education | |
| 171100000X Acupuncturist | |
| 175F00000X Naturopath | |
| 175L00000X Homeopath | |
| 207KA0200X Allergy & Immunology Allergy | |
| 208100000X Physical Medicine & Rehabilitation | |
| Enumeration Date | 2017-12-05 |
| Last Update Date | 2017-12-05 |