Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207KA0200X | Allergist | 2019-01761 | NC |
NPI | 1134407869 |
---|---|
Provider Name | Yoon M Kim |
First Address | Danville, PA 17822-4903 |
Second Address | Greensboro, NC 27401-1310 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/07/2011 |
Last Update Date | 26/08/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1031222980002 | (05) | PA |