NPI | 1548461221 |
---|---|
Former Name | SUSAN S PARK-CHUNG |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: AZ AP3469) |
Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NY 583996) |
363LP0200X Nurse Practitioner, Pediatrics (Licence: AZ RN159828/AP3469) | |
Enumeration Date | 2007-05-30 |
Last Update Date | 2018-01-24 |