| NPI | 1912948753 |
|---|---|
| Former Name | JAE EUN LEE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY F401018) |
| Additional Taxonomies | 363LC1500X Nurse Practitioner, Community Health (Licence: NY F320006) |
| Enumeration Date | 2006-06-10 |
| Last Update Date | 2010-07-14 |