Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | 2020033613 | MO |
NPI | 1003418518 |
---|---|
Provider Name | Saima Rehman Qureshi |
First Address | Branson, MO 65616-2344 |
Second Address | Branson, MO 65616-2344 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/11/2020 |
Last Update Date | 10/11/2020 |