| NPI | 1023793668 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARTIN JOSEPH RIOS Agent 720-800-3565 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family |
| Additional Taxonomies | 363LP0808X Nurse Practitioner Psychiatric/Mental Health |
| Enumeration Date | 2023-06-20 |
| Last Update Date | 2023-10-13 |