Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0001X | Clinical Cardiac Electrophysiologist | 07671191 | MA |
NPI | 1033440474 |
---|---|
Provider Name | Dr. Pipin Kojodjojo |
First Address | Boston, MA 02111-3200 |
Second Address | Boston, MA 02115-6110 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/01/2010 |
Last Update Date | 25/01/2010 |