Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RR0500X | Rheumatology | 275352 | MA |
NPI | 1093109142 |
---|---|
Provider Name | Benjamin Patrick Persons |
First Address | Boston, MA 02118-2526 |
Second Address | Boston, MA 02118 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/03/2015 |
Last Update Date | 12/09/2018 |