Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0216X | Pediatric Rheumatologist | 2010018430 | MO |
NPI | 1679773527 |
---|---|
Provider Name | Maria Fernanda Ibarra |
First Address | Kansas City, MO 64108-4619 |
Second Address | Kansas City, MO 64108 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/07/2007 |
Last Update Date | 29/09/2010 |