Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0208X | Pediatric Infectious Diseases | 62167 | CO |
NPI | 1255674446 |
---|---|
Provider Name | Juri Boguniewicz |
First Address | Littleton, CO 80127-2627 |
Second Address | Littleton, CO 80127-2627 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/04/2013 |
Last Update Date | 31/07/2019 |