Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 11415615-1205 | UT |
N | 111NI0900X | Internist | 11415615-1205 | UT |
Y | 207RA0201X | Internist - Allergy & Immunology | 11415615-1205 | UT |
NPI | 1407134224 |
---|---|
Provider Name | Mili Shum |
First Address | Valhalla, NY 10595-1524 |
Second Address | West Harrison, NY 10604-2906 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/07/2011 |
Last Update Date | 12/11/2021 |