Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0106X | Orthopaedic Hand Surgeon | R4260 | TX |
NPI | 1215348446 |
---|---|
Provider Name | Hannah Kim |
First Address | Chicago, IL 60625 |
Second Address | Fort Worth, TX 76104-4917 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/05/2014 |
Last Update Date | 28/09/2020 |