| NPI | 1366050007 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAE LIN Office Manager 314-925-0903 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine Geriatric Medicine |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| Enumeration Date | 2020-07-20 |
| Last Update Date | 2020-12-16 |