Medical school: UNIVERSITY OF MINNESOTA MEDICAL SCHOOL
Graduated: 1996
NPI: 1992897276
Practice Locations (2)
PEND OREILLE COUNTY PUBLIC HOSPITAL DISTRICT NO 1
714 W PINE ST
Newport, WA 991569046
PEND OREILLE COUNTY PUBLIC HOSPITAL DISTRICT NO 1
714 W PINE ST
NEWPORT, WA 991569046
5094472441
Source: CMS National Downloadable File, September 2026.