Graduated: 2016
NPI: 1104274448
Practice Locations (5)
15 GRUMMAN RD W, SUITE 1400
BETHPAGE, NY 117145029
5102 N OAK CREEK DR
EAGLE MOUNTAIN, UT 840055443
2621 S 3270
Salt Lake City, UT 841191119
PO BOX, SUITE 27128
SALT LAKE CITY, UT 84127
870 E 9400 S, SUITE 200
Sandy, UT 840943686
Source: CMS National Downloadable File, September 2026.