Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0102X | Surgical Critical Care | DR.0058646 | CO |
NPI | 1003071903 |
---|---|
Provider Name | Dr. Juan Pablo Idrovo |
First Address | Aurora, CO 80042-0429 |
Second Address | Aurora, CO 80045 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/07/2008 |
Last Update Date | 11/06/2018 |