Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | 77989 | MA |
NPI | 1003863259 |
---|---|
Provider Name | Garo Damla |
First Address | Toronto, ON M3B3G2 |
Second Address | Jamaica Plain, MA 02130 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/05/2006 |
Last Update Date | 08/07/2007 |