Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0204X | Pediatric Emergency Doctor | DR.0066577 | CO |
NPI | 1073003695 |
---|---|
Provider Name | Nithin Ravi |
First Address | Denver, CO 80205 |
Second Address | Aurora, CO 80045-7106 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/05/2018 |
Last Update Date | 03/12/2021 |