Medical school: UNIVERSITY OF CALIFORNIA, IRVINE, CALIFORNIA COLLEGE OF MEDICINE
Graduated: 1997
NPI: 1316982044
Practice Locations (1)
ORIGIN HEALTH LLC
2831 FORT MISSOULA RD, SUITE 232
MISSOULA, MT 598047479
4065235650
Source: CMS National Downloadable File, September 2026.