Medical school: MEDICAL COLLEGE OF WISCONSIN
Graduated: 1982
NPI: 1013956705
Practice Locations (2)
SAINT ALPHONSUS REGIONAL MEDICAL CENTER INC
323 E RIVERSIDE DR, SUITE 224
EAGLE, ID 836166865
2083026000
SAINT ALPHONSUS REGIONAL MEDICAL CENTER INC
3025 W CHERRY LN
MERIDIAN, ID 836428531
Source: CMS National Downloadable File, September 2026.