| NPI | 1467913863 |
|---|---|
| Former Name | DONG HYUN KIM |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: NJ 22DI02806400) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2019-03-28 |
| Last Update Date | 2021-08-27 |