Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 174V00000X | Clinical Ethicist | 20052 | CO |
NPI | 1558702423 |
---|---|
Provider Name | Jonathan Ward |
First Address | Boulder, CO 80302-4717 |
Second Address | Boulder, CO 80302-4717 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/07/2013 |
Last Update Date | 08/07/2013 |