| NPI | 1568909836 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIRSTEN E BACA Member 443-413-3130 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: UT 9777824-1205) |
| Enumeration Date | 2017-01-25 |
| Last Update Date | 2017-01-25 |