Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208800000X | Urologist | 252332 | MA |
N | 208800000X | Urologist | 4301097311 | MI |
NPI | 1043585557 |
---|---|
Provider Name | Dr. Quoc-Dien Trinh |
First Address | Boston, MA 02115-6105 |
Second Address | Boston, MA 02115-6105 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/03/2012 |
Last Update Date | 15/07/2013 |