Medical school: ST. LOUIS COLLEGE OF PHYSICIANS AND SURGEONS
Graduated: 1987
Also: SPORTS MEDICINE
NPI: 1922092741
Practice Locations (2)
POCATELLO HEALTH SERVICES LLC
2240 E CTR ST
POCATELLO, ID 832012600
2082332100
POCATELLO HEALTH SERVICES LLC
777 HOSPITAL WAY
POCATELLO, ID 832015175
Source: CMS National Downloadable File, September 2026.