Medical school: UNIVERSITY OF ILLINOIS COLLEGE OF MED (CHI/PEOR/ROCK/CHM-URB)
Graduated: 2002
NPI: 1821281866
Practice Locations (2)
1101 26TH ST S, CREDENTIALING
Great Falls, MT 594055161
PO BOX, SUITE 6010
GREAT FALLS, MT 59406
Source: CMS National Downloadable File, September 2026.