| NPI | 1962619502 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY JOYCE KEEFE Practice Manager 636-978-1772 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2080A0000X Pediatrics, Adolescent Medicine (Licence: MO 105226) |
| Enumeration Date | 2007-05-16 |
| Last Update Date | 2020-08-22 |