NPI | 1932627486 |
---|---|
Entity Type | Organization |
Authorized Contact | SECIL SCHODROSKI Owner 314-722-6555 |
Organization Subpart ? | No |
Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: MO 2014014296) |
Enumeration Date | 2017-09-05 |
Last Update Date | 2018-11-09 |