| NPI | 1922381615 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SARAH INGRAM Office Manager 636-937-3121 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: MO in process) |
| Enumeration Date | 2011-09-20 |
| Last Update Date | 2014-10-21 |