Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RX0202X | Medical Oncology | 246077 | MA |
NPI | 1073817524 |
---|---|
Provider Name | Dr. Elgene Lim |
First Address | Boston, MA 02446 |
Second Address | Boston, MA 02446 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/12/2010 |
Last Update Date | 27/12/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
246077 | MASSACHUSETTS MEDICAL BOARD LICENSE NUMBER (01) | MA |