Individual
BO BAO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
75 FRANCIS ST, BOSTON, MA 02115
(587) 785-8651
Mailing address
11131 85 AVE NW, UNIT 101, EDMONTON, ALBERTA T6G0W-7
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
03/18/2024
Last updated
02/21/2025
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