Individual
JIM LU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
75 FRANCIS ST, BOSTON, MA 02115-6106
(617) 732-5500
Mailing address
4592 N 425 E, PROVO, UT 84604-5987
(801) 318-1653
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
3016758
MA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
01/19/2022
Last updated
05/16/2024
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