Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0106X | Oral and Maxillofacial Pathology | DL12121 | MA |
NPI | 1174946990 |
---|---|
Provider Name | Maher Alnammary |
First Address | Boston, MA 02115-6110 |
Second Address | Boston, MA 02115-6110 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/01/2014 |
Last Update Date | 30/01/2014 |