| NPI | 1487106175 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HEATHER M GANO Owner 970-420-3471 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine |
| Enumeration Date | 2016-10-27 |
| Last Update Date | 2016-12-07 |