Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0203X | Pediatric Critical Care Doctor | 2021030364 | MO |
NPI | 1285926238 |
---|---|
Provider Name | Richard Zachary Betters |
First Address | Kansas City, MO 64180-2843 |
Second Address | Springfield, MO 65807-5210 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/05/2011 |
Last Update Date | 03/08/2021 |