Individual
DR. SOO KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
2012-01074
NC
207L00000X
Anesthesiology Physician
Primary
62215
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1316100480
—
WI
Enumeration date
07/08/2008
Last updated
09/23/2014
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