| 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 |