| NPI | 1619114105 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEVE P SIGMAN Manager 314-629-4262 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2009-01-21 |
| Last Update Date | 2020-03-30 |