Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | L-224800 | MA |
NPI | 1013043843 |
---|---|
Provider Name | Anne Hodges Light |
First Address | Boston, MA 02114 |
Second Address | Boston, MA 02114 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/02/2007 |
Last Update Date | 08/07/2007 |