| NPI | 1275131021 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUSTIN MOON Owning Physician 303-715-9024 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084N0600X Psychiatry & Neurology, Clinical Neurophysiology |
| Enumeration Date | 2020-10-14 |
| Last Update Date | 2023-08-31 |