| NPI | 1912514050 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANA CONROY Director Of Credentialing 719-365-7630 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine Cardiovascular Disease |
| Additional Taxonomies | 207RE0101X Internal Medicine Endocrinology, Diabetes & Metabolism |
| 2084N0400X Psychiatry & Neurology Neurology | |
| Enumeration Date | 2020-09-23 |
| Last Update Date | 2024-08-19 |