Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | MD-11629 | HI |
N | 208000000X | Pediatrician | MD-11629 | HI |
NPI | 1063507663 |
---|---|
Provider Name | Dr. Soo Hee Kim-Delio |
First Address | Fort Hood, TX 76544-5095 |
Second Address | Fort Hood, TX 76544-5095 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/10/2006 |
Last Update Date | 15/07/2014 |