Graduated: 1995
NPI: 1063434504
Practice Locations (2)
KAWEAH DELTA HEALTH CARE DISTRICT
505 W MAIN ST, SUITE B
VISALIA, CA 932916149
5596276149
POCATELLO HEALTH SERVICES LLC
777 HOSPITAL WAY
POCATELLO, ID 832015175
2082391720
Source: CMS National Downloadable File, September 2026.