| NPI | 1124337373 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOUGLASS TAKASHI DOMOTO President 314-535-3720 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: MO R6C21) |
| Enumeration Date | 2010-10-05 |
| Last Update Date | 2010-10-05 |