| NPI | 1134352396 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RATAN K NALLAMOTHU Physician 636-579-6148 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: MO 2009008003) |
| Enumeration Date | 2009-09-03 |
| Last Update Date | 2009-09-03 |