Individual
LARA WINE LEE
Active
Individual
LARA WINE LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
37328
SC
207NP0225X
Pediatric Dermatology Physician
Primary
37328
SC
208000000X
Pediatrics Physician
MT190407
PA
Other
Enumeration date
07/23/2007
Last updated
10/22/2020
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