| NPI | 1548804800 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEREK PAUL PRUNI Member 480-200-7846 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine |
| Enumeration Date | 2019-10-30 |
| Last Update Date | 2020-07-07 |