Medical school: UNIVERSITY OF UTAH SCHOOL OF MEDICINE
Graduated: 1995
NPI: 1801812854
Practice Locations (2)
1151 E 3900 S NUMBER, B150
SALT LAKE CITY, UT 841241253
27020 PACIFIC HWY S, SUITE A 502
KENT, WA 98032
Source: CMS National Downloadable File, September 2026.