Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207T00000X | Neurosurgeon | DR.0063720 | CO |
N | 207T00000X | Neurosurgeon | MD-45124 | IA |
N | 207T00000X | Neurosurgeon | R-9419 | IA |
NPI | 1033476569 |
---|---|
Provider Name | Dr. Yasunori Nagahama |
First Address | Aurora, CO 80042-0429 |
Second Address | Aurora, CO 80045-7106 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/04/2012 |
Last Update Date | 17/07/2020 |