Medical school: UNIVERSITY OF SOUTHERN CALIFORNIA KECK SCHOOL OF MEDICINE
Graduated: 1993
NPI: 1902921083
Practice Locations (1)
ACTIVENW LLC
301 N 3RD ST
COEUR D ALENE, ID 838142861
2082152210
Source: CMS National Downloadable File, September 2026.
This site republishes official CMS/Medicare Care Compare data. It is not medical advice and does not recommend any specific hospital or treatment — for medical decisions, talk to a doctor.
Medical school: UNIVERSITY OF SOUTHERN CALIFORNIA KECK SCHOOL OF MEDICINE
Graduated: 1993
NPI: 1902921083
ACTIVENW LLC
301 N 3RD ST
COEUR D ALENE, ID 838142861
2082152210
Source: CMS National Downloadable File, September 2026.