| NPI | 1326712209 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | YOUN JEA KIM Np 716-650-5720 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2021-08-04 |
| Last Update Date | 2024-03-27 |