Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | DR.0057563 | CO |
Y | 111NI0900X | Internist | DR.0057563 | CO |
NPI | 1003254202 |
---|---|
Provider Name | Ms. Prachi Toni Patel |
First Address | Boulder, CO 80301-2709 |
Second Address | Longmont, CO 80501-6568 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/06/2013 |
Last Update Date | 20/07/2017 |