| NPI | 1679851752 |
|---|---|
| Other Name | JI HYUN LYDIA KO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: OR 3508) |
| Additional Taxonomies | 152WL0500X Optometrist, Low Vision Rehabilitation (Licence: MN 3296) |
| Enumeration Date | 2011-07-24 |
| Last Update Date | 2015-02-05 |