| NPI | 1902929441 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANNA ROSE NIESEN President 314-781-8405 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MO R8939) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: MO R8939) |
| Enumeration Date | 2007-04-09 |
| Last Update Date | 2020-08-22 |