Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0106X | Oral and Maxillofacial Pathology | 00000000 | VA |
NPI | 1912599879 |
---|---|
Provider Name | Soo-Yeon Sohn |
First Address | New York, NY 10029-6504 |
Second Address | New York, NY 10029-6504 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/02/2021 |
Last Update Date | 10/02/2021 |