Medical school: UNIVERSITY OF CALIFORNIA - SCHOOL OF OPTOMETRY
Graduated: 2004
NPI: 1013220979
Practice Locations (1)
NEZ PERCE TRIBAL HEALTH AUTHORITY
111 BEVER GRADE RD, NIMIIPUU HEALTH
LAPWAI, ID 835400367
2086214946
Source: CMS National Downloadable File, September 2026.