| NPI | 1982843439 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIK DANIELS Physisican 314-741-4411 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: MO 111769) |
| Enumeration Date | 2009-02-06 |
| Last Update Date | 2010-03-24 |