Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204F00000X | Transplant Surgeon | 246669 | MA |
N | 208200000X | Surgeon | 246669 | MA |
N | 208600000X | Surgeon | 246669 | MA |
NPI | 1790903524 |
---|---|
Provider Name | Caroline Simon |
First Address | Burlington, MA 01805-0001 |
Second Address | Burlington, MA 01805-0001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/04/2007 |
Last Update Date | 28/09/2020 |