Graduated: 2020
NPI: 1932797248
Practice Locations (2)
IDAHO UROLOGIC INSTITUTE PA
2855 E MAGIC VIEW DR
MERIDIAN, ID 836426245
2086394900
IDAHO UROLOGIC INSTITUTE PA
6195 E HUNT AVE
NAMPA, ID 836878317
2086394900
Source: CMS National Downloadable File, September 2026.