Medical school: MIDWESTERN UNIVERSITY, CHICAGO COLLEGE OF OSTEOPATHIC MED
Graduated: 1994
Also: SPORTS MEDICINE
NPI: 1093705071
Practice Locations (1)
IDAHO SPORTS MEDICINE INSTITUTE PA
1188 W UNIVERSITY DR
BOISE, ID 837063009
2083368250
Source: CMS National Downloadable File, September 2026.