Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | 10719 | CO |
NPI | 1043428295 |
---|---|
Provider Name | Susan Bargas |
First Address | Denver, CO 80211-1948 |
Second Address | Lakewood, CO 80226-3007 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/05/2007 |
Last Update Date | 08/07/2007 |