| NPI | 1538841101 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONAH MINK President 716-523-8814 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2023-08-03 |
| Last Update Date | 2024-10-11 |