Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207SG0201X | Clinical Genetics (M.D.) | 152105 | MA |
Y | 2084N0400X | Neurologist | 152105 | MA |
N | 2084N0400X | Neurologist | 356086-1205 | UT |
N | 2084N0600X | Clinical Neurophysiologist | 152105 | MA |
NPI | 1003906637 |
---|---|
Provider Name | Kathryn J. Swoboda |
First Address | Boston, MA 02114-2621 |
Second Address | Boston, MA 02114-2621 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/10/2006 |
Last Update Date | 11/03/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G65385 | (05) | UT |