Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0007X | Plastic Surgeon (Head & Neck) | 288601 | MA |
NPI | 1609442912 |
---|---|
Provider Name | Dr. Meera Gopu |
First Address | Brighton, MA 02135-2907 |
Second Address | Brighton, MA 02135-2907 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/05/2021 |
Last Update Date | 28/05/2021 |