Medical school: AT STILL UNIVERSITY OF HEALTH SCIENCES, COLLEGE OF OSTEO MED, KIRKSVILLE
Graduated: 1984
NPI: 1184780694
Practice Locations (1)
SHOSHONE BANNOCK TRIBES, INC
717 MISSION RD
FORT HALL, ID 832030306
2084783995
Source: CMS National Downloadable File, September 2026.