Medical school: UNIVERSITY OF TEXAS MEDICAL BRANCH AT GALVESTON
Graduated: 1987
NPI: 1427043934
Practice Locations (1)
POUDRE VALLEY MEDICAL GROUP LLC
1760 E KEN PRATT BLVD, SUITE 201 WOMENS CARE LPMC
LONGMONT, CO 805045311
7207185200
Source: CMS National Downloadable File, September 2026.