Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0003X | Hematology & Oncology | 2016014158 | MO |
NPI | 1063767317 |
---|---|
Provider Name | Dr. Natasha Catherine Edwin |
First Address | Saint Louis, MO 63110-1010 |
Second Address | Appleton, WI 54911-8735 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/07/2012 |
Last Update Date | 22/06/2018 |