| NPI | 1396035721 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SANJAY SHARMA Doctor 636-296-7510 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine (Licence: MO 110133) |
| Enumeration Date | 2011-04-19 |
| Last Update Date | 2011-05-03 |