| NPI | 1972820017 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMMY PHILLIPS Authorized Official 302-598-9139 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology |
| Additional Taxonomies | 208VP0000X Pain Medicine Pain Medicine |
| 208VP0014X Pain Medicine Interventional Pain Medicine | |
| Enumeration Date | 2010-04-29 |
| Last Update Date | 2018-05-14 |