| NPI | 1770662959 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: CO 32744) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: CO DC13789) |
| 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: CO 32744) | |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: CO 32744) | |
| 2081S0010X Physical Medicine & Rehabilitation, Sports Medicine (Licence: CO 32744) | |
| Enumeration Date | 2006-11-06 |
| Last Update Date | 2010-12-02 |