Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | 2010013751 | MO |
N | 2080P0210X | Pediatric Nephrologist | 57.008703 | OH |
NPI | 1467654293 |
---|---|
Provider Name | Dr. Elizabeth Chathaparampil Abraham |
First Address | Saint Louis, MO 63119-4405 |
Second Address | Saint Louis, MO 63119-4405 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/06/2007 |
Last Update Date | 22/03/2021 |