Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0202X | Pediatric Cardiologist | 251180 | MA |
NPI | 1154679413 |
---|---|
Provider Name | Dr. Virginie Beausejour Ladouceur |
First Address | Boston, MA 02130-2550 |
Second Address | Boston, MA 02115-5724 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/08/2012 |
Last Update Date | 16/08/2012 |