| NPI | 1518417708 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW JOHN GIBFRIED Owner 314-401-6210 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MO 2005023728) |
| Enumeration Date | 2016-10-11 |
| Last Update Date | 2016-10-11 |