| NPI | 1871968958 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS MOSHIRI Owner 424-344-0980 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: AZ 34825) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: AZ 34825) |
| Enumeration Date | 2015-12-01 |
| Last Update Date | 2020-04-23 |