| NPI | 1649790080 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRYAN KNEPPER Owner 617-571-3680 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2017-06-27 |
| Last Update Date | 2017-06-27 |