Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208800000X | Urologist | 277590 | MA |
NPI | 1013496843 |
---|---|
Provider Name | Alice Xiao Yu |
First Address | Cambridge, MA 02139-3182 |
Second Address | Boston, MA 02114-2621 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/08/2018 |
Last Update Date | 25/03/2019 |