Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0200X | Occupational Therapist - Pediatrics | 07030 | MD |
NPI | 1013685130 |
---|---|
Provider Name | Yun Kim |
First Address | Sandy Spring, MD 20860-1338 |
Second Address | Germantown, MD 20874-2293 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/09/2021 |
Last Update Date | 02/09/2021 |