Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 226337 | MA |
Y | 2086S0105X | Surgery of the Hand | 226337 | MA |
NPI | 1447251152 |
---|---|
Provider Name | Dr. Jung Mi Lee Haisman |
First Address | Dartmouth, MA 02747-1242 |
Second Address | Dartmouth, MA 02747-1242 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/08/2005 |
Last Update Date | 07/02/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H82191 | (02) | MA |