Medical school: CALIFORNIA SCHOOL OF PODIATRIC MEDICINE
Graduated: 1999
NPI: 1487688990
Practice Locations (3)
150 N 200
MALAD CITY, ID 832521239
2082351777
1777 E CLARK ST, SUITE 220
POCATELLO, ID 832013357
2082351777
366 S 3RD
SODA SPRINGS, ID 832761559
2082351777
Source: CMS National Downloadable File, September 2026.