Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174V00000X | Clinical Ethicist | 1149 | CO |
NPI | 1578856209 |
---|---|
Provider Name | Jan Galvin |
First Address | Colorado Springs, CO 80921-2411 |
Second Address | Colorado Springs, CO 80921-2411 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/05/2011 |
Last Update Date | 27/05/2011 |