| NPI | 1558542506 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOE JENSEN Administrator 314-821-5850 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine |
| Enumeration Date | 2007-11-19 |
| Last Update Date | 2011-06-17 |