| NPI | 1457022063 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREGORY WONG Owner 602-418-6687 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine |
| Additional Taxonomies | 207LA0401X Anesthesiology, Addiction Medicine |
| 2084P0800X Psychiatry & Neurology, Psychiatry | |
| Enumeration Date | 2021-09-23 |
| Last Update Date | 2021-09-23 |