Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0300X | Geriatric Medicine | 41951 | CO |
NPI | 1114010436 |
---|---|
Provider Name | Dr. Bookanakere Niranjan |
First Address | Golden, CO 80403-7445 |
Second Address | Golden, CO 80403-7445 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/09/2006 |
Last Update Date | 19/11/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
70737703 | (05) | CO |
G81305 | (02) |