Graduated: 2017
NPI: 1922527001
Practice Locations (2)
DENVER HEALTH AND HOSPITAL AUTHORITY
777 BANNOCK ST
DENVER, CO 802044507
3034366000
POUDRE VALLEY MEDICAL GROUP LLC
1750 E KEN PRATT BLVD, UCHEALTH
LONGMONT, CO 805045311
9702377848
Source: CMS National Downloadable File, September 2026.