| NPI | 1619383106 |
|---|---|
| Former Name | JESSICA S LEE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: WA OD60465096) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: LA 1807-741AT) |
| Enumeration Date | 2014-07-07 |
| Last Update Date | 2021-04-28 |