NPI | 1750399358 |
---|---|
Entity Type | Organization |
Authorized Contact | PUNYAMURTULA S KISHORE President 617-738-4640 |
Organization Subpart ? | No |
Primary Taxonomy | 207Q00000X Family Medicine |
Additional Taxonomies | 207QA0401X Family Medicine, Addiction Medicine |
207R00000X Internal Medicine | |
Enumeration Date | 2006-08-03 |
Last Update Date | 2020-08-22 |