Medical school: UNIVERSITY OF WASHINGTON SCHOOL OF MEDICINE
Graduated: 2019
NPI: 1821652199
Practice Locations (2)
1950 E CLARK ST, SUITE 100
POCATELLO, ID 832013315
2088064581
HEALTH WEST INC
465 MEMORIAL DR
POCATELLO, ID 832014008
20823278621122
Source: CMS National Downloadable File, September 2026.