| NPI | 1316128846 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELA RENEE CHAMBERLIN Manager 314-750-0935 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: MO R7H29) |
| Enumeration Date | 2007-11-27 |
| Last Update Date | 2009-04-17 |