| NPI | 1790832178 |
|---|---|
| Former Name | DAISY KIM |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: TN DS11935) |
| Additional Taxonomies | 122300000X Dentist (Licence: CA 54622) |
| 122300000X Dentist (Licence: AK 1325) | |
| 122300000X Dentist (Licence: HI CSDT 83) | |
| Enumeration Date | 2007-01-05 |
| Last Update Date | 2023-06-29 |