Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0205X | Pediatric Endocrinologist | 71390 | MA |
NPI | 1346301058 |
---|---|
Provider Name | Paul M Martha |
First Address | Boxford, MA 01921-2532 |
Second Address | Cambridge, MA 02139 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/12/2006 |
Last Update Date | 08/07/2007 |