| NPI | 1972091825 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CATHY EGHIGIAN Director, Credentialing Operations 314-273-0770 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2018-04-26 |
| Last Update Date | 2018-04-26 |