Medical school: UNIVERSITY OF NEBRASKA COLLEGE OF MEDICINE
Graduated: 1982
NPI: 1780950014
Practice Locations (1)
DHS OFFICE OF FINANCIAL SERVICES IRS EOPC BMRC EOTC OSH OSH-P
29398 RECOVERY WAY
JUNCTION CITY, OR 974488447
5414652554
Source: CMS National Downloadable File, September 2026.