Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 170100000X | Medical Geneticist |
NPI | 1275767105 |
---|---|
Provider Name | Dr. Birgit Funke |
First Address | Cambridge, MA 02139-4232 |
Second Address | Cambridge, MA 02139-4232 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/05/2009 |
Last Update Date | 06/05/2009 |