Medical school: GEORGETOWN UNIVERSITY SCHOOL OF MEDICINE
Graduated: 1999
NPI: 1063500163
Practice Locations (2)
MA BO INC
1555 W SHORELINE DR, SUITE 100
BOISE, ID 837029107
8014855055
MA BO INC
466 E 500, SUITE 200
SALT LAKE CTY, UT 841113350
8014855055
Source: CMS National Downloadable File, September 2026.