Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207U00000X | Nuclear Medicine Specialist | 2005010199 | MO |
NPI | 1740306067 |
---|---|
Provider Name | Dr. Asif Moinuddin |
First Address | Saint Louis, MO 63144-1717 |
Second Address | Saint Louis, MO 63144-1717 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/03/2007 |
Last Update Date | 08/07/2007 |