Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0700X | Prosthodontist | 000034-1 | NY |
NPI | 1013267061 |
---|---|
Provider Name | Dr. Daewon Haam |
First Address | New York, NY 10032-3725 |
Second Address | New York, NY 10032-3725 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/09/2012 |
Last Update Date | 18/09/2012 |