Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204D00000X | Neuromusculoskeletal Medicine (NMM) | 41654 | CO |
NPI | 1609831031 |
---|---|
Provider Name | Eric Gish |
First Address | Aurora, CO 80011-6750 |
Second Address | Aurora, CO 80011-6750 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/04/2006 |
Last Update Date | 08/07/2007 |