| NPI | 1912014606 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURA ANNETTE HAWKINS Office Manager 314-822-7033 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: MO R6940) |
| Enumeration Date | 2006-08-25 |
| Last Update Date | 2008-09-23 |