Graduated: 2014
NPI: 1437564895
Practice Locations (4)
2035 CORTE DEL NOGAL, SUITE 200
CARLSBAD, CA 920111445
2965 E TARPON DR, SUITE 150
Meridian, ID 836429007
119 S VALLEY DR PMB 178 A
NAMPA, ID 836862974
16 ATLANTIC AVE, FL 2
LYNBROOK, NY 115633046
Source: CMS National Downloadable File, September 2026.