| NPI | 1235300286 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAIRA MIR ASADULLAH Owner 636-916-9091 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine Geriatric Medicine (Licence: MO 2005014820) |
| Enumeration Date | 2008-03-18 |
| Last Update Date | 2008-04-24 |