Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122300000X | Dentist | DN1859089 | MA |
NPI | 1003488321 |
---|---|
Provider Name | Dr. Maryam Aslam |
First Address | Cambridge, MA 02139-3308 |
Second Address | Cambridge, MA 02139-3308 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/07/2021 |
Last Update Date | 15/07/2021 |