Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0122X | Plastic and Reconstructive Surgery | DR-43664 | CO |
NPI | 1295952729 |
---|---|
Provider Name | Geoffrey Kim |
First Address | Centennial, CO 80122-2387 |
Second Address | Centennial, CO 80122-2387 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/04/2007 |
Last Update Date | 08/07/2007 |