Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0216X | Pediatric Rheumatologist | 04-41528 | KS |
NPI | 1942566864 |
---|---|
Provider Name | Mrs. Leslie Ann Favier |
First Address | Kansas City, MO 64108-4619 |
Second Address | Kansas City, MO 64108 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/04/2012 |
Last Update Date | 27/01/2022 |