Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0200X | Radiology | 03481 | MD |
Y | 213ER0200X | Radiology | 03481 | MD |
NPI | 1164581922 |
---|---|
Provider Name | Melissa Kang Yoon |
First Address | Baltimore, MD 21236-0310 |
Second Address | Perry Hall, MD 21128-8933 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/12/2006 |
Last Update Date | 08/07/2007 |