Medical school: LOMA LINDA UNIVERSITY SCHOOL OF MEDICINE
Graduated: 1999
NPI: 1548243199
Practice Locations (2)
GRITMAN MEDICAL CENTER INC
700 S MAIN ST
MOSCOW, ID 838433056
GRITMAN MEDICAL CENTER INC
719 S MAIN ST
MOSCOW, ID 838433041
2088836779
Source: CMS National Downloadable File, September 2026.