| NPI | 1659149953 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SANDRA FRIDAY Credentialer 702-800-8988 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine |
| Additional Taxonomies | 207LA0401X Anesthesiology, Addiction Medicine |
| 207LP2900X Anesthesiology, Pain Medicine | |
| Enumeration Date | 2023-12-15 |
| Last Update Date | 2023-12-15 |