Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207ND0900X | Dermatopathologist | 48092-20 | WI |
NPI | 1679563738 |
---|---|
Provider Name | Dr. Abigail J Lee |
First Address | San Antonio, TX 78236-5638 |
Second Address | San Antonio, TX 78236-5638 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/10/2005 |
Last Update Date | 17/09/2019 |