| NPI | 1679671929 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM ELVIS HINES Chairman/President 314-830-1900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MO MDR4G28) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 4301050425) |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2007-11-05 |