| NPI | 1134970163 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MANUEL ENRIQUE LOPEZ DIEZ Physician Owner 386-222-7746 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine |
| Additional Taxonomies | 208VP0000X Pain Medicine, Pain Medicine |
| Enumeration Date | 2024-03-28 |
| Last Update Date | 2024-03-28 |