NPI | 1609242619 |
---|---|
Entity Type | Organization |
Authorized Contact | SECIL A SCHODROSKI Owner 314-722-6555 |
Organization Subpart ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2014014296) |
Enumeration Date | 2015-08-13 |
Last Update Date | 2015-08-13 |