| NPI | 1689261885 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GAVIN PUTHOFF Physician/Owner 314-405-9556 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208600000X Surgery |
| Additional Taxonomies | 207VG0400X Obstetrics & Gynecology, Gynecology |
| Enumeration Date | 2020-12-22 |
| Last Update Date | 2022-03-15 |