Graduated: 2001
NPI: 1932100559
Practice Locations (4)
BANNER - UNIVERSITY PHYSICIAN SPECIALISTS LLC
1441 N 12TH ST, FL 2
PHOENIX, AZ 850062837
8442424664
ST LUKES CLINIC-TREASURE VALLEY LLC
333 N 1ST ST, SUITE 150
BOISE, ID 837026135
2083817360
ST LUKES CLINIC-TREASURE VALLEY LLC
608 W HAYS ST
BOISE, ID 837025511
2083815970
ST LUKES CLINIC-TREASURE VALLEY LLC
610 W HAYS ST
BOISE, ID 837025511
2083815970
Source: CMS National Downloadable File, September 2026.