Graduated: 2021
NPI: 1164176772
Practice Locations (3)
ONEIDA COUNTY HOSPITAL
220 BANNOCK ST
MALAD CITY, ID 832525068
2087662600
CARIBOU MEMORIAL HOSPITAL
300 S 3RD
SODA SPRINGS, ID 832761559
CARIBOU MEDICAL CENTER, INC
300 S 3RD
SODA SPRINGS, ID 832761559
20854733417503
Source: CMS National Downloadable File, September 2026.