| NPI | 1649696303 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMGED ELTAHIR Owner 314-729-2856 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: MO 2006027556) |
| Enumeration Date | 2014-03-05 |
| Last Update Date | 2015-06-04 |