| NPI | 1922260587 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DORIS ANN GLAUBER Office Manager 618-628-2588 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: IL 036089938) |
| Enumeration Date | 2008-06-25 |
| Last Update Date | 2020-07-22 |