Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | ETLL-1003 | MA |
N | 111NI0900X | Internist | ETLL-1003 | MA |
NPI | 1003439944 |
---|---|
Provider Name | Sara Murdock Sobolewski |
First Address | Boston, MA 02215-5491 |
Second Address | Boston, MA 02215-5491 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/05/2020 |
Last Update Date | 27/10/2020 |