| NPI | 1699950394 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES H OLIVERA President 928-783-0092 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: AZ 37868) |
| Additional Taxonomies | 208VP0000X Pain Medicine, Pain Medicine (Licence: AZ 37868) |
| Enumeration Date | 2008-01-01 |
| Last Update Date | 2008-01-01 |