Individual
SANGWON LEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
18701 N 67TH AVE, GLENDALE, AZ 85308-7100
(623) 561-1000
Mailing address
7865 W BELL RD # 1066, PEORIA, AZ 85382-3803
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
277046
AZ
Other
Enumeration date
10/17/2024
Last updated
10/17/2024
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