Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | R-7268 | IA |
Y | 2080P0207X | Pediatric Hematology-Oncologist | 37477 | IA |
NPI | 1013126705 |
---|---|
Provider Name | Janice M. R. Staber |
First Address | Iowa City, IA 52242-1009 |
Second Address | Iowa City, IA 52242-1009 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/05/2007 |
Last Update Date | 07/01/2011 |