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Individual

JENNIFER KIM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA

Contact information

Practice address
8450 GOLD SUNSET WAY, COLUMBIA, MD 21045-7407
(410) 963-3345
Mailing address
8450 GOLD SUNSET WAY, COLUMBIA, MD 21045-7407
(410) 963-3345

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
C0002128
MD

Other

Enumeration date
11/04/2005
Last updated
07/12/2007
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