Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207W00000X | Ophthalmologist | 282936 | MA |
NPI | 1033565874 |
---|---|
Provider Name | Dan Liu |
First Address | Boston, MA 02116-5603 |
Second Address | Worcester, MA 01605-1932 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/05/2016 |
Last Update Date | 09/09/2021 |