Medical school: UNIVERSITY OF MISSOURI, COLUMBIA SCHOOL OF MEDICINE
Graduated: 1968
Also: GENERAL PRACTICE
Offers telehealth
NPI: 1063456648
Practice Locations (1)
SHOSHONE BANNOCK TRIBES, INC
717 MISSION RD
FORT HALL, ID 832030306
2084783995
Source: CMS National Downloadable File, September 2026.