| NPI | 1568745776 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VICTORIA ZAVALA Medical Doctor 618-751-4121 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 336.088977) |
| Enumeration Date | 2011-09-23 |
| Last Update Date | 2011-09-23 |