Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PP0204X | Pediatric Emergency Physician | 235015 | MA |
NPI | 1275791931 |
---|---|
Provider Name | Raina Mitelia Paul |
First Address | Boston, MA 02215-4315 |
Second Address | Boston, MA 02115-5724 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/05/2008 |
Last Update Date | 25/04/2013 |