Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN1001X | Nutrition | 1952 | MA |
NPI | 1063499408 |
---|---|
Provider Name | Dr. Margaret Ann Tabor |
First Address | Boston, MA 02108-1001 |
Second Address | Cambridge, MA 02138-4302 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/12/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U66526 | (02) | MA |