Individual
JI AH KIM
Active
Individual
JI AH KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
0001214465
VA
207L00000X
Anesthesiology Physician
95001716
CA
367500000X
Certified Registered Nurse Anesthetist
0024175781
VA
367500000X
Certified Registered Nurse Anesthetist
Primary
95001716
CA
Other
Enumeration date
11/20/2017
Last updated
01/24/2024
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