Medical school: UNIVERSITY OF ILLINOIS COLLEGE OF MED (CHI/PEOR/ROCK/CHM-URB)
Graduated: 2001
NPI: 1972542181
Practice Locations (1)
POUDRE VALLEY HEALTH CARE INC
1025 PENNOCK PL, SUITE 121
FORT COLLINS, CO 805243250
9704958980
Source: CMS National Downloadable File, September 2026.