Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0204X | Pediatric Emergency Doctor | MDRB07 | MO |
NPI | 1245340512 |
---|---|
Provider Name | Jane Fisher Orling |
First Address | Saint Louis, MO 63104-1623 |
Second Address | Saint Louis, MO 63128-2106 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/08/2006 |
Last Update Date | 08/07/2007 |