Graduated: 2021
NPI: 1780178814
Practice Locations (2)
IDAHO SKIN SURGERY CENTER PC
1906 S VISTA AVE
BOISE, ID 837053453
IDAHO SKIN SURGERY CENTER PC
1906 S VISTA AVE, SUITE A
BOISE, ID 837053453
2084331114
Source: CMS National Downloadable File, September 2026.