Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | TRN11193 | FL |
NPI | 1003017021 |
---|---|
Provider Name | Andrew Lim |
First Address | Jacksonville, FL 32207-4208 |
Second Address | Jacksonville, FL 32207-4208 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/05/2007 |
Last Update Date | 30/06/2010 |