Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204D00000X | Neuromusculoskeletal Medicine (NMM) | 2019023833 | MO |
NPI | 1225681356 |
---|---|
Provider Name | Dr. Daniel Kraft |
First Address | Kirksville, MO 63501-2866 |
Second Address | Kirksville, MO 63501-6401 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/07/2019 |
Last Update Date | 17/07/2019 |