Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207W00000X | Ophthalmologist | 5315056243 | MI |
NPI | 1033474820 |
---|---|
Provider Name | Dr. Gene Kim |
First Address | New York, NY 10010 |
Second Address | Bronx, NY 10467-2404 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/07/2012 |
Last Update Date | 27/04/2018 |