| NPI | 1730352394 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HENRY W. CLEVER Physician/Owner 636-916-1300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: R4P68) |
| Additional Taxonomies | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: MO R4P68) |
| Enumeration Date | 2008-04-03 |
| Last Update Date | 2017-03-01 |