| NPI | 1154888014 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAREN STRONG Director 314-973-9571 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0129X |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical |
| 363L00000X Nurse Practitioner | |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2019-02-27 |
| Last Update Date | 2026-03-06 |