Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 235927 | MA |
N | 111NI0900X | Internist | 235927 | MA |
Y | 207RG0300X | Geriatric Medicine | 235927 | MA |
NPI | 1013123504 |
---|---|
Provider Name | Dr. Dae Hyun Kim |
First Address | Boston, MA 02215-5501 |
Second Address | Boston, MA 02215-5501 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/05/2007 |
Last Update Date | 27/04/2010 |