| NPI | 1184756082 |
|---|---|
| Professional Name | JAY WON PARK |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CA C56214) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX G9781) |
| Enumeration Date | 2007-03-09 |
| Last Update Date | 2017-02-07 |