| NPI | 1932934353 |
|---|---|
| Other Name | GONZAGA INTERVENTIONAL PAIN MANAGEMENT |
| Entity Type | Organization |
| Authorized Contact | MELVIN R GONZAGA Owner 240-362-7128 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 208VP0000X |
| Enumeration Date | 2024-09-05 |
| Last Update Date | 2024-09-05 |