Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0700X | Prosthodontist | 9674 | MA |
NPI | 1205014081 |
---|---|
Provider Name | Dr. Tariq Rowaihy |
First Address | Boston, MA 02215-1274 |
Second Address | Boston, MA 02215-1274 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/02/2008 |
Last Update Date | 05/02/2008 |