Graduated: 2012
NPI: 1043659196
Practice Locations (2)
MOUNTAIN PINE DERMATOLOGY PLLC
4664 N PENNGROVE WAY, SUITE 100
MERIDIAN, ID 836467442
2088987467
MOUNTAIN PINE DERMATOLOGY PLLC
110 RATTLESNAKE AVE
MOUNTAIN HOME, ID 836474219
2088987467
Source: CMS National Downloadable File, September 2026.