Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RA0201X | Internist - Allergy & Immunology | 2001009169 | MO |
NPI | 1144262825 |
---|---|
Provider Name | Dr. Shirley S Joo |
First Address | Saint Louis, MO 63123-6962 |
Second Address | Saint Louis, MO 63123-6962 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/06/2006 |
Last Update Date | 03/12/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
205801004 | (05) | MO |
H57863 | (02) |