Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0129X | Vascular Surgeon | 249719 | MA |
NPI | 1093952939 |
---|---|
Provider Name | Dr. Sarah Carlson |
First Address | West Roxbury, MA 02132-4927 |
Second Address | West Roxbury, MA 02132-4927 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/01/2009 |
Last Update Date | 02/10/2020 |