| NPI | 1285687145 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH PRAVOOT GIRA Authorized Official 314-369-3536 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QS0132X Clinic/Center, Ophthalmologic Surgery (Licence: MI 61-6816) |
| Enumeration Date | 2006-05-18 |
| Last Update Date | 2026-03-20 |