Medical school: STATE UNIVERSITY OF NY UPSTATE MEDICAL UNIVERSITY
Graduated: 1994
NPI: 1508907387
Practice Locations (2)
DHHS PHS NAIHS CHINLE COMPREHENSIVE HEALTH CARE FACILITY
HIGHWAY 191 AND HOSPITAL RD
CHINLE, AZ 865038000
92867470307030
MOUNTAIN ORTHOPAEDICS LLC
1551 RENAISSANCE TOWNE DR, SUITE 500
BOUNTIFUL, UT 840107678
8012957200
Source: CMS National Downloadable File, September 2026.