Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0208X | Pediatric Infectious Diseases | 74830 | MA |
NPI | 1629025952 |
---|---|
Provider Name | Deborah Claire Molrine |
First Address | Newton, MA 02461-1305 |
Second Address | Jamaica Plain, MA 02130 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/05/2006 |
Last Update Date | 08/07/2007 |