Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0300X | Geriatric Medicine | 2003017187 | MO |
NPI | 1023026804 |
---|---|
Provider Name | Chantri Trinh |
First Address | Saint Louis, MO 63111-1462 |
Second Address | St Louis, MO 63110 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/08/2006 |
Last Update Date | 25/10/2018 |