Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | 2021019151 | MO |
NPI | 1033773726 |
---|---|
Provider Name | Amelia Ni |
First Address | Saint Louis, MO 63110-1003 |
Second Address | Saint Louis, MO 63110-1003 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/04/2019 |
Last Update Date | 09/08/2021 |