| NPI | 1750561064 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELE ROBERTS Gnp 636-244-4500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner Gerontology (Licence: MO 103362) |
| Enumeration Date | 2007-11-05 |
| Last Update Date | 2007-11-21 |