| NPI | 1992836134 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VICTORIA MARLENE SIMS Office Manager 314-878-8744 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: MO 100507) |
| Enumeration Date | 2007-03-08 |
| Last Update Date | 2020-08-22 |