| NPI | 1841885142 |
|---|---|
| Former Name | DEOKCHOL KIM |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NV 835784) |
| Additional Taxonomies | 261QU0200X Clinic/Center, Urgent Care |
| Enumeration Date | 2021-03-08 |
| Last Update Date | 2023-02-01 |