Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080A0000X | Adolescent Medicine | MD34398 | MD |
NPI | 1235219536 |
---|---|
Provider Name | Kirsten B Hawkins |
First Address | Boston, MA 02241-8283 |
Second Address | Washington, DC 20007-2113 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/10/2006 |
Last Update Date | 07/03/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
010084105 | (05) | VA |
037427100 | (05) | DC |
404515700 | (05) | MD |
I48704 | (02) |