Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204D00000X | Neuromusculoskeletal Medicine (NMM) | 0000000000000 | NY |
NPI | 1558943381 |
---|---|
Provider Name | Dr. Grace Jihyun Kim |
First Address | Bronx, NY 10457-1526 |
Second Address | Bronx, NY 10457-2545 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/04/2021 |
Last Update Date | 25/06/2021 |