| NPI | 1184809030 |
|---|---|
| Former Name | JERRY K LEE |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RA0401X Internal Medicine, Addiction Medicine (Licence: VA 0101057543) |
| Additional Taxonomies | 207RA0401X Internal Medicine, Addiction Medicine (Licence: MD D0054211) |
| 208D00000X General Practice (Licence: VA 0101057543) | |
| 208D00000X General Practice (Licence: VA 01010575543) | |
| 208D00000X General Practice (Licence: MD D0054211) | |
| Enumeration Date | 2008-01-09 |
| Last Update Date | 2024-05-20 |