Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0400X | Neurologist | 254140 | MA |
NPI | 1033343256 |
---|---|
Provider Name | Katharine Ames Nicholson |
First Address | Boston, MA 02114-2781 |
Second Address | Boston, MA 02114-2781 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/05/2009 |
Last Update Date | 18/08/2014 |