| NPI | 1265023121 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALEXANDER ROSE Owner / Md 314-380-8764 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Additional Taxonomies | 2084F0202X Psychiatry & Neurology, Forensic Psychiatry |
| Enumeration Date | 2021-02-02 |
| Last Update Date | 2024-05-18 |