NPI | 1316114663 |
---|---|
Entity Type | Organization |
Authorized Contact | GABRIEL LUIS BONILLA Medical Director And LLC Member 623-780-1563 |
Organization Subpart ? | No |
Primary Taxonomy | 261QP3300X Clinic/Center, Pain (Licence: AZ 32912) |
Enumeration Date | 2008-05-14 |
Last Update Date | 2023-03-07 |