| NPI | 1437490505 |
|---|---|
| Former Name | MIN KIM |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: VA 0401414415) |
| Additional Taxonomies | 122300000X Dentist (Licence: VA 0401414415) |
| 204E00000X Oral & Maxillofacial Surgery (Licence: VA 0401414415) | |
| Enumeration Date | 2013-03-14 |
| Last Update Date | 2023-09-13 |