| NPI | 1174085757 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MOHAMMED SHAZAD WADA Member 404-273-6996 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine |
| Additional Taxonomies | 207L00000X Anesthesiology |
| 208VP0014X Pain Medicine, Interventional Pain Medicine | |
| Enumeration Date | 2019-04-03 |
| Last Update Date | 2019-04-03 |