NPI | 1609864545 |
---|---|
Former Name | JISUN LEE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 208M00000X Hospitalist (Licence: WA MD61059119) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX M4275) |
207Q00000X Family Medicine (Licence: PA MD443886) | |
207Q00000X Family Medicine (Licence: WA MD61059119) | |
Enumeration Date | 2005-10-13 |
Last Update Date | 2024-04-22 |