| NPI | 1467631259 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HASHIM RAZA Director 314-434-3114 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: MO 101414) |
| Enumeration Date | 2007-10-29 |
| Last Update Date | 2010-04-15 |