Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | 46792 | CO |
NPI | 1013063791 |
---|---|
Provider Name | Kristine Knuti Rodrigues |
First Address | Denver, CO 80204-4507 |
Second Address | Denver, CO 80204-4507 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/01/2007 |
Last Update Date | 30/03/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
48703281 | (05) | CO |