NPI | 1871762385 |
---|---|
Entity Type | Organization |
Authorized Contact | ROBERT P. POETZ Owner 314-291-0505 |
Organization Subpart ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: MO 29351) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MO 152467) |
Enumeration Date | 2008-02-28 |
Last Update Date | 2008-05-22 |