Individual
DR. JISOO L SHIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
O.D.
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
27OA00549600
NJ
152W00000X
Optometrist
27TO00087000
NJ
152W00000X
Optometrist
Primary
T006053-1
NY
Other
Enumeration date
03/20/2007
Last updated
05/05/2008
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