| NPI | 1407487457 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL GAITAN Owner 314-498-1977 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism |
| Enumeration Date | 2020-01-29 |
| Last Update Date | 2021-03-01 |