Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | 288194 | MA |
NPI | 1982024303 |
---|---|
Provider Name | Xibei Jia |
First Address | Worcester, MA 01605-2903 |
Second Address | Hyannis, MA 02601-3145 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/04/2014 |
Last Update Date | 12/10/2021 |