Medical school: UNIVERSITY OF UTAH SCHOOL OF MEDICINE
Graduated: 1995
Also: FAMILY PRACTICE
NPI: 1992719504
Practice Locations (2)
127 S 500 E 600, SUITE 1
SALT LAKE CITY, UT 841021959
PO BOX, SUITE 299
SALT LAKE CITY, UT 84110
Source: CMS National Downloadable File, September 2026.