| NPI | 1912747106 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBRA KAY MOON WADELTON Billing And Credentialing Manager 720-923-1250 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Enumeration Date | 2024-05-28 |
| Last Update Date | 2024-12-18 |