Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174V00000X | Clinical Ethicist |
NPI | 1568884872 |
---|---|
Provider Name | Mr. Miles Richard Smith |
First Address | Aurora, CO 80045 |
Second Address | Aurora, CO 80045 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/01/2014 |
Last Update Date | 07/01/2014 |