| NPI | 1083258610 |
|---|---|
| Other Name | JOHN KIM |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2019-11-06 |
| Last Update Date | 2024-06-26 |