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1336879501
CHAN WOO KIM
PROVIDENCE, RI
NPI
1336879501
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
(Licence: RI LP05521)
Enumeration Date
2022-06-12
Last Update Date
2022-06-12
Business Address
CHAN WOO KIM MD
593 EDDY ST
PROVIDENCE, RI 02903-4923
Phone number: 401-444-4741
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Mailing Address
CHAN WOO KIM MD
593 EDDY ST
PROVIDENCE, RI 02903-4923
Phone number: 401-444-4741
Copy
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