| NPI | 1225314248 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN RABUN Psychiatrist 314-251-7720 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: MO R8N45) |
| Enumeration Date | 2011-10-24 |
| Last Update Date | 2011-10-24 |