Medical school: UNIVERSITY OF TEXAS MEDICAL SCHOOL AT HOUSTON
Graduated: 1990
NPI: 1962517086
Practice Locations (1)
POUDRE VALLEY MEDICAL GROUP LLC
2121 E HARMONY RD, UNIT 330 UCHMG SURGICAL SPEC FC
FORT COLLINS, CO 805283403
9702215878
Source: CMS National Downloadable File, September 2026.