| NPI | 1477794063 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRICIA PAVLOPOULOS Physician 314-355-1166 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: MO 106145) |
| Enumeration Date | 2009-03-12 |
| Last Update Date | 2009-03-12 |