Doctor Name: | DARIO BYUNG SAN ROMAN |
NPI Number: | 1528462975 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | AGACNP/FNP |
License Number: | APN.0991479-NP |
Business Practice Address: | 410 Benedicta Ave Trinidad, CO - 810822005 |
Business Phone Number: | 7198464262 |
Business Fax Number: | 7198463540 |
Mailing Address: | Po Box 481, TRINIDAD |
State: | CO |
Postal Code: | 81082 |
Phone Number: | 7192891139 |
Fax Number: | |
NPI Enumeration Date: | 10/14/2014 |
NPI Last Update Date: | 04/04/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LA2100X |
License Number: | APN.0991479-NP |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | CO |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Acute Care |
Taxonomy Definition: |