| NPI | 1154608909 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AIDEN M CLARKE Owner 619-564-7463 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: CA G64292) |
| Enumeration Date | 2011-11-08 |
| Last Update Date | 2012-03-09 |