| NPI | 1679964449 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHARIQ LATIF President 904-654-3918 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: FL ME113190) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: FL ME113190) |
| Enumeration Date | 2015-02-13 |
| Last Update Date | 2015-12-02 |