| NPI | 1073374856 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AURORA PETERSEN FRERS Office Manager 813-502-9540 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine Interventional Pain Medicine |
| Enumeration Date | 2024-01-19 |
| Last Update Date | 2024-01-19 |