| NPI | 1497856124 |
|---|---|
| Other Name | JISOO PARK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NJ 27OA00616900) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: CA opt 13015 t) |
| Enumeration Date | 2006-09-26 |
| Last Update Date | 2009-04-19 |