Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204E00000X | Oral & Maxillofacial Surgeon | DS042358 | PA |
NPI | 1245885060 |
---|---|
Provider Name | Dr. Sean Jia Hoong Lim |
First Address | Philadelphia, PA 19107-4259 |
Second Address | Philadelphia, PA 19107-5211 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/08/2019 |
Last Update Date | 08/08/2019 |