Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RE0101X | Endocrinologist (Diabetes Doctor) | 88302 | GA |
NPI | 1063808509 |
---|---|
Provider Name | Dr. Jae Hyung Sim |
First Address | Dallas, TX 75390-9030 |
Second Address | Boston, MA 02114-2605 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/04/2015 |
Last Update Date | 23/04/2021 |