Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 2015033471 | MO |
Y | 2080P0204X | Pediatric Emergency Doctor | 2015033471 | MO |
NPI | 1083966790 |
---|---|
Provider Name | Dr. Irene A Oriaifo |
First Address | Saint Louis, MO 63104-1003 |
Second Address | Saint Louis, MO 63104-1003 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/10/2012 |
Last Update Date | 18/01/2021 |