| NPI | 1700832367 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEONARD D GAUM Owner President 314-569-1750 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: MO R4A96) |
| Additional Taxonomies | 208800000X Urology (Licence: MO 103702) |
| Enumeration Date | 2006-05-25 |
| Last Update Date | 2012-10-02 |