Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0402X | Child Neurologist | 264265 | MA |
N | 2084N0600X | Clinical Neurophysiologist | 264265 | MA |
NPI | 1144582776 |
---|---|
Provider Name | Daniel Davila-Williams |
First Address | Boston, MA 02115-5724 |
Second Address | Boston, MA 02115-5724 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/06/2012 |
Last Update Date | 16/01/2020 |