Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 239230 | MA |
Y | 2080P0216X | Pediatric Rheumatologist | 239230 | MA |
NPI | 1528226271 |
---|---|
Provider Name | Dr. Mindy S Lo |
First Address | Boston, MA 02115 |
Second Address | Boston, MA 02115 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/05/2008 |
Last Update Date | 26/08/2015 |