Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0106X | Oral and Maxillofacial Pathology | 22D102297200 | NJ |
NPI | 1235145970 |
---|---|
Provider Name | Dr. John Soh |
First Address | Cherry Hill, NJ 08002-3041 |
Second Address | Cherry Hill, NJ 08002-3041 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/08/2006 |
Last Update Date | 21/02/2008 |