Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0205X | Pediatric Endocrinologist | RIB88 | MO |
NPI | 1396850749 |
---|---|
Provider Name | Sherida E Tollefsen |
First Address | St Louis, MO 63110 |
Second Address | St. Louis, MO 63104 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/08/2006 |
Last Update Date | 09/01/2008 |