| NPI | 1528345295 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MITCHELL LIBERMAN Owner 314-858-1858 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MO 112767) |
| 208D00000X General Practice (Licence: MO 112767) | |
| Enumeration Date | 2011-11-09 |
| Last Update Date | 2019-02-11 |