Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0200X | Radiology | CHR-6290 | CO |
Y | 213ER0200X | Radiology | CHR-6290 | CO |
NPI | 1740305556 |
---|---|
Provider Name | Dr. Dane A. L. Borman |
First Address | Denver, CO 80222-4358 |
Second Address | Denver, CO 80222-4358 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/03/2007 |
Last Update Date | 05/11/2009 |