| NPI | 1811363583 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LIZETTE ETCHEVERRY Business Administrator 970-242-7060 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CO 31768) |
| Enumeration Date | 2015-08-18 |
| Last Update Date | 2023-04-03 |