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Individual
DR. DANIEL BORAM PARK
Active
Individual
DR. DANIEL BORAM PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
34501
SC
2080P0204X
Pediatric Emergency Medicine (Pediatrics) Physician
Primary
34501
SC
390200000X
Student in an Organized Health Care Education/Training Program
—
CT
Other
Enumeration date
06/22/2009
Last updated
01/18/2017
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