Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0207X | Pediatric Hematology-Oncologist | DR.0065428 | CO |
NPI | 1043468945 |
---|---|
Provider Name | Lisa Louise Rubin Hartman |
First Address | Aurora, CO 80042-0429 |
Second Address | Aurora, CO 80045-7106 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/09/2008 |
Last Update Date | 29/01/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
171353901 | (05) | TX |
171353903 | (05) | TX |
171353905 | (05) | TX |
190685101 | (05) | TX |
8BQ023 | BCBS (01) | TX |