| NPI | 1154536779 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID J CALLAHAN Treasurer 314-275-7070 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084N0402X Psychiatry & Neurology Neurology with Special Qualifications in Child Neurology (Licence: MO R6J44) |
| Enumeration Date | 2007-05-14 |
| Last Update Date | 2020-08-22 |