| NPI | 1699246645 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAM DUY NGUYEN Owner 918-901-9701 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology Pain Medicine |
| Additional Taxonomies | 2081P2900X Physical Medicine & Rehabilitation Pain Medicine |
| 208VP0014X Pain Medicine Interventional Pain Medicine | |
| Enumeration Date | 2018-12-16 |
| Last Update Date | 2021-09-27 |