Medical school: CALIFORNIA SCHOOL OF PODIATRIC MEDICINE
Graduated: 1990
NPI: 1093717787
Practice Locations (2)
1630 23RD AVE, SUITE 1001
LEWISTON, ID 835016350
2087433688
1630 23RD AVE, SUITE 1001
LEWISTON, ID 835016355
Source: CMS National Downloadable File, September 2026.