Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | MD181338 | OR |
N | 111NI0900X | Internist | MD181338 | OR |
Y | 207RX0202X | Medical Oncology | 287844 | MA |
NPI | 1093133811 |
---|---|
Provider Name | Jia Luo |
First Address | Boston, MA 02215-5450 |
Second Address | Boston, MA 02215-5450 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/03/2014 |
Last Update Date | 17/12/2021 |