Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VE0102X | Reproductive Endocrinologist | DR.0063987 | CO |
NPI | 1013371335 |
---|---|
Provider Name | Ivy L Lersten |
First Address | Aurora, CO 80045-2570 |
Second Address | Aurora, CO 80045-2570 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/04/2016 |
Last Update Date | 29/06/2020 |