| NPI | 1477833044 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL QUINTANA Medical Doctor 970-669-3298 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2011-08-26 |
| Last Update Date | 2011-08-26 |