Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204D00000X | Neuromusculoskeletal Medicine (NMM) | 33294 | CO |
NPI | 1306928478 |
---|---|
Provider Name | Lisa Robin Rittel |
First Address | Boulder, CO 80303 |
Second Address | Boulder, CO 80303 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/10/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01332949 | (05) | CO |
C76801 | (02) |