Medical school: SOUTHERN CALIFORNIA COLLEGE OF OPTOMETRY
Graduated: 1997
NPI: 1831285626
Practice Locations (3)
15 S 100
BEAVER, UT 847137854
4354382020
15 S 100, PO BOX 111
BEAVER, UT 847130111
15 S 100, PO BOX 111
BEAVER, UT 847137854
Source: CMS National Downloadable File, September 2026.