Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081P2900X | Pain Medicine | DR.0065363 | CO |
NPI | 1205229945 |
---|---|
Provider Name | Bradley Richard Hakim |
First Address | Lone Tree, CO 80124-2744 |
Second Address | Lone Tree, CO 80124-2744 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/03/2015 |
Last Update Date | 12/11/2020 |