Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XX0005X | Sports Medicine Orthopaedic Surgeon | DR.0064337 | CO |
NPI | 1093154361 |
---|---|
Provider Name | Dr. Jessica Hea Soo Lee |
First Address | Aurora, CO 80042-0429 |
Second Address | Aurora, CO 80045-2541 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/06/2013 |
Last Update Date | 29/07/2020 |