| NPI | 1104940840 |
|---|---|
| Former Name | ILWOONG KOH |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MI 2901019018) |
| Additional Taxonomies | 122300000X Dentist (Licence: MI 2901019018) |
| Enumeration Date | 2007-03-19 |
| Last Update Date | 2024-02-05 |