Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QG0300X | Family Doctor - Geriatric Medicine | OS019995 | PA |
NPI | 1164803391 |
---|---|
Provider Name | Seo Choi |
First Address | Philadelphia, PA 19178-3311 |
Second Address | Allentown, PA 18105-7017 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/06/2015 |
Last Update Date | 14/08/2019 |