| NPI | 1376278325 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANTHONY CLAVO Md 469-221-6000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine |
| Additional Taxonomies | 208VP0014X Pain Medicine, Interventional Pain Medicine |
| Enumeration Date | 2022-07-22 |
| Last Update Date | 2022-09-16 |