| NPI | 1740960574 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHEILA ANTIMONE Office Manager 781-944-4044 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213E00000X Podiatrist |
| Additional Taxonomies | 213ES0131X |
| Enumeration Date | 2023-07-18 |
| Last Update Date | 2023-09-21 |