Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | 265940 | MA |
NPI | 1083905756 |
---|---|
Provider Name | Vishnu Kannabiran |
First Address | Chelmsford, MA 01824-2738 |
Second Address | Chelmsford, MA 01824-2738 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/04/2011 |
Last Update Date | 23/03/2017 |