Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 175L00000X | Homeopath |
NPI | 1033353677 |
---|---|
Provider Name | Ms. Kim Marie Purdy |
First Address | Quincy, MA 02169-5213 |
Second Address | Quincy, MA 02169-5213 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/04/2009 |
Last Update Date | 27/04/2009 |