| NPI | 1801831045 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAMER THANAVARO Md 618-433-1861 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease |
| Additional Taxonomies | 207RI0011X Internal Medicine, Interventional Cardiology |
| Enumeration Date | 2006-06-19 |
| Last Update Date | 2021-08-11 |