| NPI | 1003015306 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARY GHISELLI Owner 303-888-7742 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CO 2415) |
| Enumeration Date | 2007-07-16 |
| Last Update Date | 2007-07-16 |