| NPI | 1144739079 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE B RASMUSSEN Physician 618-304-8985 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology |
| Additional Taxonomies | 207LA0401X Anesthesiology, Addiction Medicine |
| 207LP2900X Anesthesiology, Pain Medicine | |
| Enumeration Date | 2017-09-22 |
| Last Update Date | 2022-07-21 |