Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0203X | Pediatric Critical Care Doctor | 256264 | MA |
NPI | 1215378435 |
---|---|
Provider Name | Dr. Peta-Maree Ann Alexander |
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 | 16/07/2013 |
Last Update Date | 12/02/2014 |