Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0201X | Pediatric Allergist | 28834 | CO |
NPI | 1598840225 |
---|---|
Provider Name | Andrew Liu |
First Address | Denver, CO 80206-2761 |
Second Address | Denver, CO 80206-2761 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/10/2006 |
Last Update Date | 07/05/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01288349 | (05) | CO |
E48462 | (02) | CO |