| NPI | 1578694881 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CYNTHIA JEAN WHITENER Office Manager 314-525-4934 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MO 109530) |
| Enumeration Date | 2007-03-08 |
| Last Update Date | 2008-03-05 |