Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0208X | Pediatric Infectious Diseases | 31792 | MA |
NPI | 1164558748 |
---|---|
Provider Name | Georges Peter |
First Address | Brookline, MA 02445-5701 |
Second Address | Brookline, MA 02445-5701 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/02/2007 |
Last Update Date | 08/07/2007 |