Medical school: UNIVERSITY OF KENTUCKY COLLEGE OF MEDICINE
Graduated: 2023
NPI: 1528774114
Practice Locations (2)
PO BOX, SUITE 712260
Salt Lake City, UT 841712260
3811 E VIEWCREST DR
SALT LAKE CITY, UT 841243932
Source: CMS National Downloadable File, September 2026.