Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156F00000X | Technician/Technologist |
NPI | 1104465061 |
---|---|
Provider Name | Roseann T Biason |
First Address | Saint Louis, MO 63103-2377 |
Second Address | Saint Louis, MO 63103-2377 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/12/2019 |
Last Update Date | 24/12/2019 |