| NPI | 1972921401 |
|---|---|
| Former Name | JENNIE PARK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: IL 036171647) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: TX S0764) |
| Enumeration Date | 2014-04-01 |
| Last Update Date | 2024-08-23 |