| NPI | 1992131528 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANE AIGUIER Director 617-308-5361 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: MA dn21077) |
| Enumeration Date | 2013-09-14 |
| Last Update Date | 2013-09-14 |