Individual
LILY JIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3901 BEAUBIEN ST, DETROIT, MI 48201-2119
(301) 222-7086
Mailing address
6036 CHATSWORTH LN, BETHESDA, MD 20814-2206
(301) 222-7086
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
63178842
KAISER PERMANENTE
MD
Enumeration date
03/04/2015
Last updated
03/04/2015
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