| NPI | 1154793248 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DARIN M. MINKIN Administrator 314-965-8622 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Additional Taxonomies | 163WR0006X Registered Nurse, Registered Nurse First Assistant |
| Enumeration Date | 2015-10-28 |
| Last Update Date | 2018-12-07 |