Individual
DA MI KO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
X
Contact information
Practice address
360 HUNTINGTON AVE, BOSTON, MA 02115-5005
(617) 373-4923
Mailing address
360 HUNTINGTON AVE, BOSTON, MA 02115-5005
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN2332914
MA
Other
Enumeration date
02/26/2026
Last updated
02/26/2026
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