Individual
ETIN-OSA OSA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
11 N SOUTHWOOD DR, NASHUA, NH 03063-1803
(603) 880-1590
Mailing address
11 N SOUTHWOOD DR, NASHUA, NH 03063-1803
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
16522
NH
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/19/2009
Last updated
10/22/2014
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