| NPI | 1902061310 |
|---|---|
| Former Name | KI HO KANG |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0700X Dentist Prosthodontics (Licence: CA 105801) |
| Additional Taxonomies | 1223P0700X Dentist Prosthodontics (Licence: MA 20572) |
| Enumeration Date | 2008-07-24 |
| Last Update Date | 2022-07-12 |