| NPI | 1508303710 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS MOSHIRI Manager 424-322-0980 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology |
| 2084N0600X | |
| 208VP0000X | |
| 208VP0014X Pain Medicine, Interventional Pain Medicine | |
| Enumeration Date | 2017-01-25 |
| Last Update Date | 2020-04-23 |