Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN1001X | Nutrition | 2880 | MA |
NPI | 1275591810 |
---|---|
Provider Name | Dr. Pierre Daniel Abdilmasih |
First Address | Franklin, MA 02038-2792 |
Second Address | Roxbury, MA 02119-2152 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/05/2006 |
Last Update Date | 08/07/2007 |