| NPI | 1568974335 |
|---|---|
| Former Name | JOON HEO MITCHELL |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CA 105252) |
| Additional Taxonomies | 122300000X Dentist (Licence: VA 0401415836) |
| Enumeration Date | 2017-11-01 |
| Last Update Date | 2024-01-02 |