Medical school: TOURO UN COL OF OSTEOPATHIC MEDICINE, HENDERSON
Graduated: 2013
NPI: 1871832881
Practice Locations (1)
MOUNTAIN PINE DERMATOLOGY PLLC
4664 N PENNGROVE WAY, SUITE 100
MERIDIAN, ID 836467442
2088987467
Source: CMS National Downloadable File, September 2026.