| NPI | 1952138133 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAMEAN WILLIAM FREAS CEO 410-571-2946 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine Interventional Pain Medicine |
| Additional Taxonomies | 207L00000X Anesthesiology |
| 207LP2900X Anesthesiology Pain Medicine | |
| 208100000X Physical Medicine & Rehabilitation | |
| 208VP0000X Pain Medicine Pain Medicine | |
| Enumeration Date | 2024-09-19 |
| Last Update Date | 2024-09-19 |