| NPI | 1053945147 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSHU RAITEN Owner 210-464-4234 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine |
| Enumeration Date | 2020-02-27 |
| Last Update Date | 2020-02-27 |