Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0402X | Child Neurologist | DR0056895 | CO |
NPI | 1043519713 |
---|---|
Provider Name | Dr. Jan Martin |
First Address | Aurora, CO 80042-0429 |
Second Address | Aurora, CO 80045-7201 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/03/2011 |
Last Update Date | 28/11/2016 |