| NPI | 1942615364 |
|---|---|
| Former Name | STEPHANIE KIM |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: IN 12014639A) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 1223G0001X Dentist, General Practice (Licence: CA 64762) | |
| 1223P0221X Dentist, Pediatric Dentistry (Licence: CA 64762) | |
| Enumeration Date | 2014-06-24 |
| Last Update Date | 2025-01-22 |