Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0122X | Plastic and Reconstructive Surgery | 47231 | MN |
N | 2086S0122X | Plastic and Reconstructive Surgery | 47604-020 | WI |
NPI | 1174596993 |
---|---|
Provider Name | Paul K Lim |
First Address | Saint Paul, MN 55101-2507 |
Second Address | Saint Paul, MN 55101-2507 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/02/2006 |
Last Update Date | 06/08/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
540657900 | (05) | MN |
G49526 | (02) |