| NPI | 1740636687 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS MOSHIRI Director 424-322-0980 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: AZ 34825) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: AZ 34825) |
| 208VP0000X Pain Medicine, Pain Medicine | |
| Enumeration Date | 2016-05-10 |
| Last Update Date | 2020-04-23 |