Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0208X | Pediatric Infectious Diseases | 210658 | MA |
NPI | 1235250382 |
---|---|
Provider Name | Ouzama N Nicholson |
First Address | Freeport, NY 11520-1720 |
Second Address | Boston, MA 02119 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/04/2007 |
Last Update Date | 08/07/2007 |