| NPI | 1154868495 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS MOSHIRI Member 424-322-0980 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: AZ 34825) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: AZ 34825) |
| 2085R0202X Radiology, Diagnostic Radiology | |
| Enumeration Date | 2017-01-25 |
| Last Update Date | 2020-04-23 |