NPI | 1952852196 |
---|---|
Former Name | SUNG MIN LEE |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.0006467) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA058420) |
Enumeration Date | 2016-10-24 |
Last Update Date | 2024-05-07 |