Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0102X | Surgical Critical Care | 151835 | MA |
NPI | 1215977749 |
---|---|
Provider Name | Michael B Yaffe |
First Address | West Roxbury, MA 02132-3809 |
Second Address | West Roxbury, MA 02132-3809 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/06/2006 |
Last Update Date | 08/07/2007 |