Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081S0010X | Sports Medicine | 263013 | MA |
Y | 213ES0000X | Sports Medicine | 263013 | MA |
NPI | 1558659482 |
---|---|
Provider Name | Dr. Jennifer Luz |
First Address | Boston, MA 02135-2907 |
Second Address | Boston, MA 02135-2907 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/07/2011 |
Last Update Date | 13/12/2016 |