Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | D0084824 | MD |
Y | 2080P0210X | Pediatric Nephrologist | MD474299 | PA |
NPI | 1780071027 |
---|---|
Provider Name | Hannah Kim |
First Address | Hershey, PA 17033-2360 |
Second Address | Hershey, PA 17033-2360 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/04/2015 |
Last Update Date | 30/07/2021 |