| NPI | 1508066275 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LYNN BOEDEKER Office Manager 314-996-8830 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: MO 2001012251) |
| Enumeration Date | 2007-07-20 |
| Last Update Date | 2007-07-20 |