Medical school: MEDICAL COLLEGE OF GEORGIA SCHOOL OF MEDICINE
Graduated: 1995
NPI: 1528020468
Practice Locations (1)
LITTLE SHELL TRIBE OF CHIPPEWA INDIANS OF MONTANA
425 SMELTER AVE NE
GREAT FALLS, MT 594041927
4067602055
Source: CMS National Downloadable File, September 2026.