Medical school: HAHNEMANN UNIVERSITY COLLEGE OF MEDICINE
Graduated: 1995
NPI: 1346345592
Practice Locations (1)
POUDRE VALLEY MEDICAL GROUP LLC
16222 W US HWY 24 220, UCHMG WOODLAND PARK OUTREACH
WOODLAND PARK, CO 808638763
7196301006
Source: CMS National Downloadable File, September 2026.