Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RR0500X | Rheumatology | 232264 | MA |
NPI | 1124238985 |
---|---|
Provider Name | Antonio Valentin |
First Address | Springfield, MA 01107-1111 |
Second Address | Springfield, MA 01107-1111 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/05/2007 |
Last Update Date | 08/07/2007 |