Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207ND0900X | Dermatopathologist | 52045 | MA |
NPI | 1255370904 |
---|---|
Provider Name | Yvonne C Hines |
First Address | Attleboro, MA 02703-2400 |
Second Address | Attleboro, MA 02703-2400 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/06/2006 |
Last Update Date | 21/05/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
6173128 | (05) | MA |