Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RX0202X | Medical Oncology | 262672 | MA |
Y | 2084N0400X | Neurologist | 262672 | MA |
NPI | 1154610376 |
---|---|
Provider Name | Dr. Kien-Ninh Ina Ly |
First Address | Boston, MA 02114 |
Second Address | Boston, MA 02114 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/03/2011 |
Last Update Date | 17/01/2019 |