| NPI | 1962120030 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IVAN E MONTALVO-OTANO President 917-523-4235 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine Interventional Pain Medicine |
| Enumeration Date | 2022-08-16 |
| Last Update Date | 2022-08-16 |