| NPI | 1548277452 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDWARD P ROSE Owner 618-257-1490 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RR0500X Internal Medicine, Rheumatology (Licence: IL 036052933) |
| Additional Taxonomies | 207RR0500X Internal Medicine, Rheumatology (Licence: MO R4736) |
| Enumeration Date | 2006-08-02 |
| Last Update Date | 2007-10-05 |