| NPI | 1689850315 |
|---|---|
| Former Name | SANG EUN LEE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: CA 55451) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA 55451) |
| Enumeration Date | 2008-01-11 |
| Last Update Date | 2022-05-23 |