| NPI | 1730524042 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA ANNE ZAKS Physician 508-823-5534 |
| Organization Subpart ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2013-05-01 |
| Last Update Date | 2013-05-01 |