| NPI | 1174222137 | 
|---|---|
| Former Name | NA YEUN PARK | 
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 1046523)  | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 1046523)  | 
| 163W00000X Registered Nurse (Licence: NY 745806)  | |
| Enumeration Date | 2023-02-28 | 
| Last Update Date | 2025-10-23 |