| NPI | 1912148511 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | QING CHEN Physisican 314-355-1166 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: MO 109507) |
| Enumeration Date | 2009-03-12 |
| Last Update Date | 2009-03-12 |