Individual
SOO H KO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGNP
Contact information
Practice address
10 GOVE ST, EAST BOSTON, MA 02128-1931
(617) 569-5899
Mailing address
10 GOVE ST, EAST BOSTON, MA 02128-1931
(617) 569-5899
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN2326883
MA
363LG0600X
Gerontology Nurse Practitioner
Primary
RN2326883
MA
Other
Enumeration date
03/01/2022
Last updated
01/19/2024
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