Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 252010 | MA |
N | 2080P0202X | Pediatric Cardiologist | 252010 | MA |
Y | 2080P0203X | Pediatric Critical Care Doctor | 252010 | MA |
NPI | 1235369224 |
---|---|
Provider Name | Dr. Kimberly Ilene Mills |
First Address | Boston, MA 02115-5724 |
Second Address | Boston, MA 02115-5724 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/07/2009 |
Last Update Date | 01/08/2019 |