Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RI0200X | Infectious Disease | 204759 | MA |
NPI | 1063528768 |
---|---|
Provider Name | Laura Kogelman |
First Address | Boston, MA 02111-1526 |
Second Address | Boston, MA 02111-1526 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/08/2006 |
Last Update Date | 08/07/2007 |