NPI | 1417391582 |
---|---|
Former Name | SUSAN SOJUNG LEE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2084N0402X Psychiatry & Neurology Neurology with Special Qualifications in Child Neurology (Licence: OH 35.136097) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2013-04-19 |
Last Update Date | 2019-05-15 |