| NPI | 1740635143 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHINY MARY ABRAHAM CEO 216-469-5575 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P2900X Psychiatry & Neurology Pain Medicine (Licence: TX Q1450) |
| Additional Taxonomies | 207RA0401X Internal Medicine Addiction Medicine (Licence: TX Q1450) |
| 2084P0800X Psychiatry & Neurology Psychiatry (Licence: TX Q0601) | |
| 2084P0800X Psychiatry & Neurology Psychiatry (Licence: TX Q1450) | |
| 208VP0000X Pain Medicine Pain Medicine | |
| Enumeration Date | 2016-05-04 |
| Last Update Date | 2020-04-17 |