| NPI | 1972633733 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THERESA PULJIC Practice Administrator 636-537-0525 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology |
| Enumeration Date | 2007-03-07 |
| Last Update Date | 2010-05-19 |