| NPI | 1225571656 |
|---|---|
| Former Name | YEIL KIM |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WI 1001602-15) |
| Additional Taxonomies | 122300000X Dentist (Licence: IL 019030664) |
| Enumeration Date | 2016-12-03 |
| Last Update Date | 2023-03-07 |