| NPI | 1134520182 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANICE ELAINE BRUNSTROM-HERNANDEZ Managing Member/ Director 314-223-3306 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: TX M5074) |
| Enumeration Date | 2014-09-09 |
| Last Update Date | 2016-01-15 |