Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086X0206X | Surgical Oncologist | 2006005525 | MO |
NPI | 1427084227 |
---|---|
Provider Name | Dr. Aislinn Sue Vaughan |
First Address | Saint Louis, MO 63195-5534 |
Second Address | Saint Charles, MO 63304-8781 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/06/2006 |
Last Update Date | 10/11/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
208237 | MO-BLUE SHIELD (01) | |
I69114 | (02) | MO |