| NPI | 1275720153 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRACY GREEN Billing Manager 314-878-0163 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: MO 34996) |
| Enumeration Date | 2007-09-25 |
| Last Update Date | 2007-09-25 |