| NPI | 1548793714 |
|---|---|
| Former Name | PAULA PARK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: GA 91237) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 303520) |
| Enumeration Date | 2017-04-05 |
| Last Update Date | 2022-08-01 |