| NPI | 1619360294 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSE R BAEZ Secretary 617-291-8669 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Additional Taxonomies | 208VP0000X Pain Medicine, Pain Medicine |
| Enumeration Date | 2015-03-06 |
| Last Update Date | 2015-06-02 |