Graduated: 1995
NPI: 1467678557
Practice Locations (2)
PRIVIA MEDICAL GROUP ARIZONA, LLC
9305 W THOMAS RD, SUITE 500
PHOENIX, AZ 850373354
6232427997
POCATELLO HEALTH SERVICES LLC
777 HOSPITAL WAY
POCATELLO, ID 832015175
2082391720
Source: CMS National Downloadable File, September 2026.