Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0106X | Oral and Maxillofacial Pathology | D10900 | MN |
NPI | 1447424098 |
---|---|
Provider Name | James Michael Hall |
First Address | Boston, MA 02111-1527 |
Second Address | Boston, MA 02111-1527 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/04/2008 |
Last Update Date | 15/04/2008 |