Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208G00000X | Cardiothoracic Vascular Surgeon | 2018030236 | MO |
NPI | 1114243995 |
---|---|
Provider Name | Dr. Graham Robertson Young Pollock |
First Address | Kansas City, MO 64111-5941 |
Second Address | Kansas City, MO 64111-5941 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/04/2010 |
Last Update Date | 28/06/2019 |