| NPI | 1174785786 |
|---|---|
| Other Name | TED PARK |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0802X Psychiatry & Neurology, Addiction Psychiatry (Licence: PA MD436597) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: RI MD14645) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MA 247886) | |
| 2084P0802X Psychiatry & Neurology, Addiction Psychiatry (Licence: MA 247886) | |
| Enumeration Date | 2008-06-26 |
| Last Update Date | 2023-02-03 |