Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0100X | Gastroenterologist | 12729 | ZZ |
NPI | 1023458072 |
---|---|
Provider Name | Dr. Julia Mcnabb-Baltar |
First Address | Boston, MA 02115-6110 |
Second Address | Boston, MA 02115-6110 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/07/2013 |
Last Update Date | 03/09/2014 |