Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | 0375 | NH |
NPI | 1003347998 |
---|---|
Provider Name | Jonathan S Lee |
First Address | Manchester, NH 03104 |
Second Address | Manchester, NH 03104 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/03/2017 |
Last Update Date | 08/09/2021 |