Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XH1200X | Occupational Therapist - Hand | 104297 | MN |
NPI | 1205256484 |
---|---|
Provider Name | Eunjin Kim |
First Address | New Hope, MN 55427-1613 |
Second Address | New Hope, MN 55427-1613 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/04/2014 |
Last Update Date | 11/10/2018 |