| NPI | 1295827665 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN DAVID GRAHAM Owner President 314-872-5601 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: MO 109904) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: IL 036092540) |
| Enumeration Date | 2006-09-29 |
| Last Update Date | 2010-04-05 |