Individual
LISA KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
13000 INDIAN SCHOOL RD NE, ALBUQUERQUE, NM 87112-4803
(505) 298-0413
Mailing address
1512 STAGECOACH RD SE, ALBUQUERQUE, NM 87123-4435
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RP00008806
NM
Other
Enumeration date
09/15/2017
Last updated
09/15/2017
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