Graduated: 2000
NPI: 1033190533
Practice Locations (3)
ONEIDA COUNTY HOSPITAL
150 N 200
MALAD CITY, ID 832521239
2087662231
ONEIDA COUNTY HOSPITAL
1754 W 1500
MALAD CITY, ID 832526594
ONEIDA COUNTY HOSPITAL
220 BANNOCK ST
MALAD CITY, ID 832525068
2087662600
Source: CMS National Downloadable File, September 2026.