| NPI | 1932666401 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAUREN DAL FARRA Physician 314-610-2199 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM1300X Clinic/Center Multi-Specialty |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 207R00000X Internal Medicine | |
| 207RC0000X Internal Medicine Cardiovascular Disease | |
| 207RG0100X Internal Medicine Gastroenterology | |
| 2084N0400X Psychiatry & Neurology Neurology | |
| 2084P0800X Psychiatry & Neurology Psychiatry | |
| Enumeration Date | 2019-02-20 |
| Last Update Date | 2019-02-20 |