| NPI | 1275932733 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMANDA JUSTINIANO Manager 803-642-6501 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology Pain Medicine |
| Additional Taxonomies | 207LP2900X Anesthesiology Pain Medicine |
| 2084N0400X Psychiatry & Neurology Neurology | |
| Enumeration Date | 2014-08-20 |
| Last Update Date | 2024-10-23 |