Medical school: KANSAS CITY UNIVERSITY OF MED & BIOSCIENCES, COLLEGE OF OSTEO MED
Graduated: 1997
NPI: 1023083680
Practice Locations (4)
PO BOX, SUITE 190930
Boise, ID 837190930
PO BOX, SUITE 190930
BOISE, ID 83719
PO BOX, SUITE 776879
CHICAGO, IL 606776789
1951 BIDHOP LN, FL 4
LOUISVILLE, KY 402181923
Source: CMS National Downloadable File, September 2026.