Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | TL0006432 | CO |
Y | 208600000X | Surgeon | TL0006432 | CO |
NPI | 1003343500 |
---|---|
Provider Name | Rachael Michele Galvin |
First Address | Overland Park, KS 66213-3474 |
Second Address | Englewood, CO 80113-3781 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/05/2017 |
Last Update Date | 15/05/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
TL0006432 | COLORADO MEDICAL BOARD PHYSICIAN TRAINING LICENSE (01) | CO |