GRANVILLE LAKE BAXA

BOSTON, MA
NPI1255182861
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy208600000X Surgery
(Licence: MA  3016241)
Enumeration Date2024-04-01
Last Update Date2024-07-01
Business Address
Dr. GRANVILLE LAKE BAXA MD
750 ALBANY ST
BOSTON, MA 02118-2520
Phone number: 617-638-6950
Mailing Address
Dr. GRANVILLE LAKE BAXA MD
750 ALBANY ST
BOSTON, MA 02118-2520
Phone number:
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