Graduated: 1997
NPI: 1750389425
Practice Locations (2)
NORTH LINCOLN COUNTY HOSPITAL DISTRICT
3100 CHANNING WAY
IDAHO FALLS, ID 834047533
3078855852
NORTH LINCOLN COUNTY HOSPITAL DISTRICT
110 HOSPITAL LN
AFTON, WY 831109409
3078855852
Source: CMS National Downloadable File, September 2026.