| NPI | 1730931890 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAMMI PATEL Director 267-712-9894 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine |
| Enumeration Date | 2024-04-03 |
| Last Update Date | 2025-05-13 |