Medical school: UNIVERSITY OF SOUTHERN CALIFORNIA KECK SCHOOL OF MEDICINE
Graduated: 2007
NPI: 1922262336
Practice Locations (2)
2985 S MERIDIAN RD, SUITE 140
MERIDIAN, ID 836427961
2985 S MERIDIAN RD, SUITE 140
MERIDIAN, ID 836428051
2089014888
Source: CMS National Downloadable File, September 2026.