Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207U00000X | Nuclear Medicine Specialist | 109864 | MO |
NPI | 1679510259 |
---|---|
Provider Name | Thomas P Dresser |
First Address | Kansas City, MO 64184-3966 |
Second Address | Columbia, MO 65212-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/06/2006 |
Last Update Date | 10/05/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
203993407 | (05) | MO |
E92133 | (02) | MO |