Medical school: UNIVERSITY OF MICHIGAN MEDICAL SCHOOL
Graduated: 2004
NPI: 1164695847
Practice Locations (1)
POUDRE VALLEY MEDICAL GROUP LLC
2315 E HARMONY RD, SUITE 160 UCHEALTH PLASTIC AND RECONSTRUCTI
FORT COLLINS, CO 805288620
9704938800
Source: CMS National Downloadable File, September 2026.