Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | 258552 | MA |
NPI | 1053638197 |
---|---|
Provider Name | Dr. Emily Stamell Ruiz |
First Address | Boston, MA 02130 |
Second Address | Boston, MA 02215 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/04/2010 |
Last Update Date | 06/04/2016 |