| NPI | 1447496708 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FAYYAZ H SAGARWALA Member 573-785-5444 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: MO 2006018918) |
| Enumeration Date | 2008-12-16 |
| Last Update Date | 2008-12-16 |