Individual
ARI AAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
2501 WALNUT ST., UNIT 204, BOULDER, CO 80302-8030
(303) 481-2366
(303) 481-2366
Mailing address
2960 INCA ST UNIT 413, DENVER, CO 80202-1105
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
DR.0064979
CO
Other
Enumeration date
04/25/2018
Last updated
06/28/2022
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