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 |