Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208800000X | Urologist | HS000029L | PA |
NPI | 1013532282 |
---|---|
Provider Name | Dr. Daniel Kim |
First Address | Bryn Mawr, PA 19010-3121 |
Second Address | Bryn Mawr, PA 19010-3121 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/06/2020 |
Last Update Date | 12/06/2020 |