Graduated: 2006
NPI: 1427143346
Practice Locations (2)
IDAHO UROLOGIC INSTITUTE PA
222 N 2ND ST, SUITE 115
BOISE, ID 837026129
2086394900
IDAHO UROLOGIC INSTITUTE PA
2855 E MAGIC VIEW DR
MERIDIAN, ID 836426245
2086394900
Source: CMS National Downloadable File, September 2026.