Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0216X | Pediatric Rheumatologist | 58796 | MA |
NPI | 1578671434 |
---|---|
Provider Name | Laurie C Miller |
First Address | Boston, MA 02111-1526 |
Second Address | Boston, MA 02111-1526 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/08/2006 |
Last Update Date | 08/07/2007 |