| NPI | 1073729604 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS V OLIVIER President 314-270-9680 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: MO 2001004855) |
| Enumeration Date | 2007-05-14 |
| Last Update Date | 2022-10-16 |