Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207T00000X | Neurosurgeon | 245705 | MA |
NPI | 1083626907 |
---|---|
Provider Name | Ann-Christine Duhaime |
First Address | Boston, MA 02114-2696 |
Second Address | Boston, MA 02114-2621 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/08/2006 |
Last Update Date | 04/08/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1008158 | (05) | VT |
30201711 | (05) | NH |
D57914 | (02) |