| NPI | 1396508420 |
|---|---|
| Former Legal Business Name | NA |
| Entity Type | Organization |
| Authorized Contact | KERRY LATCH Medical Director 210-931-7370 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine |
| Enumeration Date | 2024-02-01 |
| Last Update Date | 2024-02-01 |