| NPI | 1407857295 |
|---|---|
| Former Name | CHARLIE JI RIM |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: OR D9033) |
| Additional Taxonomies | 122300000X Dentist (Licence: CA 46521) |
| Enumeration Date | 2005-08-03 |
| Last Update Date | 2024-05-31 |