| NPI | 1306211743 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANYA ALIDA GODOY Doctor 172-714-8573 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine (Licence: FL ME85040) |
| Enumeration Date | 2015-12-10 |
| Last Update Date | 2015-12-10 |