Individual
SA RA KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
11119 ROCKVILLE PIKE STE 101, ROCKVILLE, MD 20852-3143
(301) 881-5585
Mailing address
9343 LEMON MINT CT, FAIRFAX, VA 22031-1868
(703) 297-0780
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AC005063
MD
Other
Enumeration date
02/20/2023
Last updated
02/20/2023
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