Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PP0204X | Pediatric Emergency Physician | 2020041786 | MO |
NPI | 1639748502 |
---|---|
Provider Name | Sarah Marie Ulses |
First Address | Saint Louis, MO 63141-8221 |
Second Address | Saint Louis, MO 63141-8221 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/06/2021 |
Last Update Date | 23/06/2021 |