| NPI | 1588947428 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SANG JIN LEE Owner 508-743-7888 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: MA 21084) |
| Enumeration Date | 2011-09-27 |
| Last Update Date | 2011-10-07 |