Medical school: COLLEGE OF OSTEO MED OF THE PACIFIC AT POMONA
Graduated: 1988
NPI: 1013986157
Practice Locations (2)
ST JOSEPH HOSPITAL LLC
415 6TH ST
LEWISTON, ID 835012431
2087432511
PEDIATRIX MEDICAL GROUP INC
700 W 800, SUITE 220
OREM, UT 840576316
8017146404
Source: CMS National Downloadable File, September 2026.