| NPI | 1821867029 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENYS GOLOSHCHAPOV Owner 801-205-1041 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine |
| Additional Taxonomies | 207L00000X Anesthesiology |
| Enumeration Date | 2023-12-28 |
| Last Update Date | 2024-03-15 |