| NPI | 1750562765 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PUNYAMURTULA S KISHORE President 617-383-6567 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207QA0401X Family Medicine, Addiction Medicine |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 207R00000X Internal Medicine | |
| Enumeration Date | 2007-11-19 |
| Last Update Date | 2007-11-19 |