Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207T00000X | Neurosurgeon | 2017022160 | MO |
NPI | 1083135750 |
---|---|
Provider Name | Dr. Anja Iwona Srienc |
First Address | Saint Louis, MO 63110 |
Second Address | St. Louis, MO 63110-6311 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/07/2017 |
Last Update Date | 02/09/2021 |