Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0200X | Critical Care Medicine | 2012041517 | MO |
NPI | 1013203454 |
---|---|
Provider Name | Karthik Iyer |
First Address | Saint Louis, MO 63104-1015 |
Second Address | Saint Louis, MO 63104-1015 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/06/2011 |
Last Update Date | 17/04/2017 |