| NPI | 1952555005 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MANZOOR A TARIQ M.D. 636-931-7111 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MO 133876) |
| Enumeration Date | 2008-11-14 |
| Last Update Date | 2008-11-14 |