| NPI | 1710524095 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EVERLY MILLER Credentialing Specialist 210-996-6363 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine |
| Enumeration Date | 2019-12-05 |
| Last Update Date | 2019-12-05 |