| NPI | 1902070444 | 
|---|---|
| Former Name | JASON LEE | 
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208600000X Surgery (Licence: NE 27733) | 
| Additional Taxonomies | 208600000X Surgery (Licence: MO 2013010789) | 
| Enumeration Date | 2008-04-16 | 
| Last Update Date | 2014-12-20 |