NPI | 1518396670 |
---|---|
Entity Type | Organization |
Authorized Contact | LAURA PULLUM Director 636-669-2434 |
Organization Subpart ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2013015582) |
Enumeration Date | 2013-11-08 |
Last Update Date | 2013-11-08 |