Medical school: SOUTHERN ILLINOIS UNIVERSITY SCHOOL OF MEDICINE
Graduated: 2011
NPI: 1174819817
Practice Locations (1)
COLORADO PERMANENTE MEDICAL GROUP PC
200 EMEMPLA CIRCLE, KP INTERMOUNTAIN HEALTH GOOD SAMARITAN HOSP
LAFAYETTE, CO 800263370
3033384545
Source: CMS National Downloadable File, September 2026.