| NPI | 1487895074 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMIN RADPARVAR Owner 636-939-9004 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: MO MDR1G71) |
| Enumeration Date | 2009-03-12 |
| Last Update Date | 2014-10-30 |