| NPI | 1740822618 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARIA DE ERAUSQUIN Billing Manager 314-701-0618 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry |
| Enumeration Date | 2019-10-12 |
| Last Update Date | 2020-10-28 |