| NPI | 1174071328 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANNY O'NEILL CEO 314-786-3330 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 122300000X Dentist |
| 207V00000X Obstetrics & Gynecology | |
| 208000000X Pediatrics | |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2016-09-16 |
| Last Update Date | 2016-09-16 |