Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 227480 | MA |
Y | 2080P0207X | Pediatric Hematology-Oncologist | 227480 | MA |
NPI | 1144335100 |
---|---|
Provider Name | Rachael Grace |
First Address | Boston, MA 02115 |
Second Address | Boston, MA 02115 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/08/2006 |
Last Update Date | 18/03/2015 |