Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0129X | Vascular Surgeon | 81069 | MA |
NPI | 1104863794 |
---|---|
Provider Name | E. Lynne Kelley |
First Address | Natick, MA 01760-1536 |
Second Address | Natick, MA 01760-1536 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/06/2006 |
Last Update Date | 08/07/2007 |