| NPI | 1871158287 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REBECCA A MAWUENYEGA Pharmacist/Owner 314-607-2603 |
| Organization Subpart ? | No |
| Primary Taxonomy | 163WD0400X Registered Nurse, Diabetes Educator |
| Enumeration Date | 2019-05-01 |
| Last Update Date | 2020-04-30 |