| NPI | 1154730414 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MOHAMMED ZAHID SIDDIQUI Physician 314-330-0171 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: IL 036-097325) |
| Enumeration Date | 2014-08-11 |
| Last Update Date | 2014-08-11 |