| NPI | 1609983055 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TONIA NOVELLA PEEBLES Office Manager 314-367-2766 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MO RC400) |
| Enumeration Date | 2006-08-23 |
| Last Update Date | 2020-08-22 |