Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223D0004X | Dentist Anesthesiologist | DN1856825 | MA |
NPI | 1831459205 |
---|---|
Provider Name | Lily Hu |
First Address | Taunton, MA 02780-5403 |
Second Address | Taunton, MA 02780-5403 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/05/2012 |
Last Update Date | 17/03/2018 |