| NPI | 1710682539 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATTANAM SRINIVASAN Medical Director 765-891-0721 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine |
| Enumeration Date | 2023-04-03 |
| Last Update Date | 2023-04-03 |