Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207VG0400X | Gynecologist | 258799 | MA |
Y | 207VX0000X | Obstetrician | 258799 | MA |
NPI | 1073824835 |
---|---|
Provider Name | Lily Huiling Wu |
First Address | Boston, MA 02111-1415 |
Second Address | Boston, MA 02215-5400 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/06/2010 |
Last Update Date | 11/06/2014 |