Individual
JIWON LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3820 MOUNTAIN RD STE G, PASADENA, MD 21122-2027
(410) 255-0099
Mailing address
102 MARLBORO AVE APT 7, EASTON, MD 21601-2706
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
26908
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
26908
PHARMACIST LICENSE
MD
Enumeration date
07/09/2020
Last updated
07/09/2020
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