| NPI | 1255546990 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JULIA M ZEVALLOS Owner 636-931-6090 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MO 2000160887) |
| Enumeration Date | 2007-05-14 |
| Last Update Date | 2008-06-10 |