| NPI | 1770579195 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NARGIS J AHMAD Office Manager 314-383-1100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry |
| 2084P0805X Psychiatry & Neurology, Geriatric Psychiatry | |
| 2084P0802X Psychiatry & Neurology, Addiction Psychiatry | |
| Enumeration Date | 2005-09-21 |
| Last Update Date | 2020-08-22 |