| NPI | 1053500207 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARY M GOODMAN Physician Owner 314-569-1881 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: AZ 30297) |
| Enumeration Date | 2007-10-23 |
| Last Update Date | 2023-01-17 |