Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0003X | Hematology & Oncology | 2008011531 | MO |
NPI | 1033379938 |
---|---|
Provider Name | Rolando Daniel Breier |
First Address | Jefferson City, MO 65110-4240 |
Second Address | Jefferson City, MO 65109-6023 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/06/2008 |
Last Update Date | 10/01/2014 |