| NPI | 1467597542 |
|---|---|
| Former Name | JUDY HYEYOUNG JO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: DC 1000867) |
| Additional Taxonomies | 122300000X Dentist (Licence: TX 18845) |
| 122300000X Dentist (Licence: MD 14334) | |
| Enumeration Date | 2007-02-20 |
| Last Update Date | 2009-11-04 |