Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0000X | Hematologist | 74275 | MA |
NPI | 1114018850 |
---|---|
Provider Name | Mary Paula Lutz |
First Address | Weston, MA 02493-1659 |
Second Address | Waltham, MA 02154 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/09/2006 |
Last Update Date | 08/07/2007 |