NPI | 1073608253 |
---|---|
Doing Business As | GONZAGA INTERVENTIONAL PAIN MANAGEMENT |
Entity Type | Organization |
Authorized Contact | MELVIN R GONZAGA Owner 240-362-7128 |
Organization Subpart ? | No |
Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine (Licence: MD D222148) |
Enumeration Date | 2006-10-04 |
Last Update Date | 2018-09-04 |