Medical school: UNIVERSITY OF ILLINOIS COLLEGE OF MED (CHI/PEOR/ROCK/CHM-URB)
Graduated: 1994
NPI: 1275574758
Practice Locations (1)
POUDRE VALLEY MEDICAL GROUP LLC
2500 ROCKY MOUNTAIN AVE
LOVELAND, CO 805389004
9702037250
Source: CMS National Downloadable File, September 2026.