NPI | 1184757072 |
---|---|
Entity Type | Organization |
Authorized Contact | ANANDA DESILVA Physician Owner 314-731-5555 |
Organization Subpart ? | No |
Primary Taxonomy | 207RA0000X Internal Medicine, Adolescent Medicine (Licence: MO R9845) |
Enumeration Date | 2007-03-13 |
Last Update Date | 2020-08-22 |