| NPI | 1649998212 |
|---|---|
| Former Name | JEONG HYUN PARK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA 95021384) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 95170170) |
| Enumeration Date | 2022-08-18 |
| Last Update Date | 2023-06-05 |