Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | TL.0004642 | CO |
NPI | 1013335793 |
---|---|
Provider Name | Cecilia Sorensen |
First Address | Boulder, CO 80305-6004 |
Second Address | Denver, CO 80204-4507 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/03/2014 |
Last Update Date | 31/03/2014 |