Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | MD446455 | PA |
Y | 208600000X | Surgeon | MD446455 | PA |
NPI | 1003163007 |
---|---|
Provider Name | Dr. James Hyun Soo Lee |
First Address | Hoboken, NJ 07030-5382 |
Second Address | Bremerton, WA 98310 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/08/2012 |
Last Update Date | 08/08/2012 |