| NPI | 1255622957 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK D. SIEVERS Practice Manager 314-239-0173 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine |
| Additional Taxonomies | 207R00000X Internal Medicine |
| Enumeration Date | 2011-04-28 |
| Last Update Date | 2011-04-28 |