| NPI | 1114219417 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAILAJA PULISETTY Physician/President 314-225-6015 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: MO 2005019644) |
| Enumeration Date | 2011-05-05 |
| Last Update Date | 2011-07-13 |