NPI | 1184365181 |
---|---|
Other Name | BRUCE KIM YOUM |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 122300000X Dentist (Licence: NY 063198) |
Additional Taxonomies | 122300000X Dentist (Licence: MA DN1859857) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2022-04-05 |
Last Update Date | 2023-10-06 |