Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 232483 | MA |
N | 111NI0900X | Internist | 232483 | MA |
Y | 207RG0300X | Geriatric Medicine | 232483 | MA |
NPI | 1124218227 |
---|---|
Provider Name | Won M Lee |
First Address | Boston, MA 02119 |
Second Address | Boston, MA 02118-4001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/07/2007 |
Last Update Date | 04/06/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
110080592A | (05) | MA |