Medical school: VANDERBILT UNIVERSITY SCHOOL OF MEDICINE
Graduated: 2002
Offers telehealth
NPI: 1831166636
Practice Locations (1)
POUDRE VALLEY MEDICAL GROUP LLC
1760 E KEN PRATT BLVD, SUITE 205 LPMC
LONGMONT, CO 805045311
7207185280
Source: CMS National Downloadable File, September 2026.