Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0000X | Obstetrician | 2021024909 | MO |
N | 207VX0000X | Obstetrician | M-2079 | GU |
NPI | 1003259367 |
---|---|
Provider Name | Rose Elizabeth Todd |
First Address | Kansas City, MO 64184-3966 |
Second Address | Columbia, MO 65202-0196 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/04/2013 |
Last Update Date | 05/10/2021 |