Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | 266762 | MA |
NPI | 1043454523 |
---|---|
Provider Name | Mrs. Sonia Elizabeth Xavier |
First Address | Medford, MA 02155-1643 |
Second Address | Medford, MA 02155-1643 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/04/2009 |
Last Update Date | 19/05/2011 |