| NPI | 1578181392 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SANDY VALENTINE Credentialing 970-245-2400 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 208600000X Surgery |
| Additional Taxonomies | 207Y00000X Otolaryngology |
| Enumeration Date | 2020-07-08 |
| Last Update Date | 2020-07-08 |