Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | R75578 | AZ |
NPI | 1013363589 |
---|---|
Provider Name | James Daehyun Kim |
First Address | Tucson, AZ 85724-0001 |
Second Address | Tucson, AZ 85724-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/05/2016 |
Last Update Date | 06/12/2021 |