| NPI | 1659683993 |
|---|---|
| Professional Name | KELLY PARK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: IL 036143099) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: IL 036.143099) |
| Enumeration Date | 2010-07-01 |
| Last Update Date | 2025-10-29 |