Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0700X | Prosthodontist | DN1855099 | MA |
NPI | 1205165586 |
---|---|
Provider Name | Dr. Inna Amirian |
First Address | Concord, MA 01742-2189 |
Second Address | Concord, MA 01742-2189 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/12/2009 |
Last Update Date | 23/10/2014 |