| NPI | 1275267270 |
|---|---|
| Former Name | KWONNEUNG PARK |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MN 125656) |
| Additional Taxonomies | 1835P2201X Pharmacist, Ambulatory Care (Licence: MN 125656) |
| Enumeration Date | 2022-07-14 |
| Last Update Date | 2022-07-14 |