| NPI | 1508355652 | 
|---|---|
| Former Name | HONGEUN PARK | 
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: DC MD049234) | 
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program | 
| Enumeration Date | 2018-05-03 | 
| Last Update Date | 2021-07-29 |