Medical school: NORTHWESTERN UNIVERSITY FEINBERG MEDICAL SCHOOL
Graduated: 1995
NPI: 1710073523
Practice Locations (3)
710 N 4TH ST
MONTPELIER, ID 832541050
2088471342
95 W 50
GARDEN CITY, UT 840280276
4359462777
PO BOX, SUITE 276
GARDEN CITY, UT 840280276
Source: CMS National Downloadable File, September 2026.