Medical school: UNIVERSITY OF TEXAS SOUTHWESTERN MEDICAL SCHOOL AT DALLAS
Graduated: 2001
NPI: 1134302433
Practice Locations (1)
IDAHO CLEFT AND CRANIOFACIAL PEDIATRIC PLASTIC SURGERY PA
100 E IDAHO ST, SUITE 303
BOISE, ID 837126269
2084331736
Source: CMS National Downloadable File, September 2026.