| NPI | 1720332893 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAREN WILSON Office Manager 636-536-7000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery Sports Medicine |
| Additional Taxonomies | 207LP2900X Anesthesiology Pain Medicine |
| Enumeration Date | 2012-10-29 |
| Last Update Date | 2012-10-29 |