Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207U00000X | Nuclear Medicine Specialist | 29516 | MA |
NPI | 1063406098 |
---|---|
Provider Name | Alan Ashare |
First Address | Brookline, MA 02446-9135 |
Second Address | Boston, MA 02135-2907 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/09/2005 |
Last Update Date | 10/12/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2082489 | (05) | MA |
C05798 | (02) |