Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RX0202X | Medical Oncology | TDP.0041921 | CO |
NPI | 1134478365 |
---|---|
Provider Name | Dr. Jose Ignacio Mayordomo |
First Address | Zaragoza, ZARAGOZA 50009 |
Second Address | Denver, CO 80204-4507 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/09/2012 |
Last Update Date | 08/07/2014 |