Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | 2007012455 | MO |
Y | 111NI0900X | Internist | 2007012455 | MO |
NPI | 1003019423 |
---|---|
Provider Name | Julie Anne Marx |
First Address | Kansas City, MO 64121-9672 |
Second Address | Liberty, MO 64068-9625 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/06/2007 |
Last Update Date | 25/09/2014 |