Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YP0228X | Pediatric Otolaryngology | 104366 | MO |
NPI | 1417949488 |
---|---|
Provider Name | Dr. Renee A Walker |
First Address | Joplin, MO 64804-4103 |
Second Address | Joplin, MO 64804-4103 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/08/2005 |
Last Update Date | 23/08/2011 |