Medical school: OREGON HEALTH SCIENCES UNIVERSITY SCHOOL OF MEDICINE
Graduated: 1980
NPI: 1154491579
Practice Locations (2)
269 W BROADWAY AVE
JACKSON, WY 830018635
3077336700
PO BOX, SUITE 1884
JACKSON, WY 830011884
Source: CMS National Downloadable File, September 2026.