| NPI | 1154008779 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANA CONROY Director Of Credentialing 719-364-5250 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine Cardiovascular Disease |
| Additional Taxonomies | 2086S0122X Surgery Plastic and Reconstructive Surgery |
| 2086S0129X Surgery Vascular Surgery | |
| Enumeration Date | 2023-07-05 |
| Last Update Date | 2024-06-07 |