Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RI0011X | Interventional Cardiology | 34371 | CO |
NPI | 1043294762 |
---|---|
Provider Name | Matthew Holland |
First Address | Denver, CO 80209-0599 |
Second Address | Denver, CO 80204-4507 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/12/2005 |
Last Update Date | 08/03/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F23418 | (02) |