| NPI | 1811466212 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LARS VAN ETTEN President 719-242-5811 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology |
| Additional Taxonomies | 261QP3300X Clinic/Center, Pain |
| Enumeration Date | 2018-11-15 |
| Last Update Date | 2018-11-15 |