Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223S0112X | Oral and Maxillofacial Surgeon | DN1855098 | MA |
NPI | 1073786786 |
---|---|
Provider Name | Jingyi He |
First Address | Cambridge, MA 02140 |
Second Address | Cambridge, MA 02140 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/04/2008 |
Last Update Date | 04/02/2016 |