| NPI | 1871739649 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LESLIE SHU TUNG FANG Owner 617-742-2054 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MA 39471) |
| Additional Taxonomies | 207RN0300X Internal Medicine, Nephrology (Licence: MA 39471) |
| Enumeration Date | 2008-12-30 |
| Last Update Date | 2008-12-30 |