| NPI | 1730525163 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONNA KARL BRENNAN Director Of Clinical Operations 508-880-6666 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2013-05-13 |
| Last Update Date | 2013-05-13 |