Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Y00000X | Otolaryngologist (ENT Doctor) | 39 | CA |
Y | 207YX0007X | Plastic Surgeon (Head & Neck) | 262971 | MA |
NPI | 1235450958 |
---|---|
Provider Name | Tjoson Tjoa |
First Address | Boston, MA 02114-4163 |
Second Address | Boston, MA 02114-3002 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/06/2010 |
Last Update Date | 13/10/2015 |