ROMEO GONZAGA ICASIANO

MONTROSE, CO
NPI1114928066
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy208000000X Pediatrics
(Licence: CO  37326)
Enumeration Date2005-08-02
Last Update Date2012-04-10
Business Address
-- ROMEO GONZAGA ICASIANO MD
947 SO 5TH ST
MONTROSE, CO 81401-5716
Phone number: 870-249-2421
Mailing Address
-- ROMEO GONZAGA ICASIANO MD
947 SO 5TH ST
MONTROSE, CO 81401-5716
Phone number: 870-249-2421