| NPI | 1184784274 |
|---|---|
| Former Name | YONG JOON KO |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0700X Dentist, Prosthodontics (Licence: VA 0401412988) |
| Additional Taxonomies | 122300000X Dentist (Licence: VA 0401412988) |
| 122300000X Dentist (Licence: IA 40091) | |
| 1223P0700X Dentist, Prosthodontics (Licence: IA 40091) | |
| Enumeration Date | 2006-12-11 |
| Last Update Date | 2022-07-21 |