Medical school: UNIVERSITY OF MISSOURI, COLUMBIA SCHOOL OF MEDICINE
Graduated: 1997
NPI: 1487619417
Practice Locations (2)
55 W TIETAN ST
Walla Walla, WA 993624445
55 W TIETAN ST
WALLA WALLA, WA 993624445
Source: CMS National Downloadable File, September 2026.