Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0300X | Geriatric Medicine | 49496 | CO |
NPI | 1053481382 |
---|---|
Provider Name | Dr. Herman Hasselkus |
First Address | Aurora, CO 80012-4505 |
Second Address | Aurora, CO 80012-4505 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/11/2006 |
Last Update Date | 20/07/2012 |