Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | 51382 | CO |
N | 208000000X | Pediatrician | 221184 | MA |
N | 2080P0201X | Pediatric Allergist | 51382 | CO |
NPI | 1881748226 |
---|---|
Provider Name | Kanao Otsu |
First Address | Denver, CO 80206-2761 |
Second Address | Denver, CO 80206-2761 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/01/2007 |
Last Update Date | 23/02/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
21927863 | (05) | CO |