| NPI | 1609394501 |
|---|---|
| Professional Name | NICK KIM |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: GA DN016023) |
| Additional Taxonomies | 122300000X Dentist (Licence: PA DS041448) |
| Enumeration Date | 2017-08-31 |
| Last Update Date | 2020-04-27 |