| NPI | 1548815491 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID RUSSELL HORACE Managing Member 618-235-2299 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology |
| Enumeration Date | 2019-08-07 |
| Last Update Date | 2019-08-07 |