DANIEL ILWOO PARK

JBSA FT SAM HOUSTON, TX
NPI1376070359
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy208D00000X General Practice
(Licence: NE  31126)
Additional Taxonomies390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date2017-05-22
Last Update Date2023-07-27
Business Address
DANIEL ILWOO PARK MD
3551 ROGER BROOKE DR
JBSA FT SAM HOUSTON, TX 78234-4504
Phone number: 210-916-4808
Mailing Address
DANIEL ILWOO PARK MD
CMR 388 BOX 1072
APO, AP 96208-0011
Phone number: