Medical school: OKLAHOMA STATE UNIVERSITY COLLEGE OF OSTEOPATHIC MEDICINE
Graduated: 2000
NPI: 1326000548
Practice Locations (1)
U S HEALTH DEPT OF HEALTH AND HUMAN SERVICES
100 CHEYENNE AVE
LAME DEER, MT 590430000
4064774451
Source: CMS National Downloadable File, September 2026.