Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0400X | Neurologist | 271521 | MA |
NPI | 1003179276 |
---|---|
Provider Name | Dr. Michael Gulliver Erkkinen |
First Address | Boston, MA 02115 |
Second Address | Boston, MA 02115-6110 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/06/2012 |
Last Update Date | 20/10/2017 |