Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | A112112 | CA |
N | 2080P0203X | Pediatric Critical Care Doctor | 2767051 | NY |
NPI | 1114223773 |
---|---|
Provider Name | Dr. Peggy Kim Han |
First Address | New York, NY 10065-4870 |
Second Address | Palo Alto, CA 94304-1601 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/01/2011 |
Last Update Date | 29/08/2019 |