Our Team

Get to know your care team.

Sierra Nevada Ear, Nose & Throat has been serving Reno, Carson City, Gardnerville and Fallon for 25 years. Our team of northern Nevada physicians, physician assistants, nurses and office staff are not only skilled and knowledgeable, they are also understanding and supportive. We work with you and each other to keep you informed about health issues, provide appropriate care and respond to your needs. We look forward to getting to know you.

Meet our ENT team

Paul D. Manoukian, M.D., M.P.H. 

Dr. Manoukian founded Sierra Nevada Ear, Nose & Throat in 1995, providing a whole-patient approach to ENT care. He was joined by Dr. Romaneschi in 1996. This well respected ENT doctor was named “Best Medical Specialist” in Carson City twice by the readers of the Nevada Appeal.

K. Brian Romaneschi, M.D.

Dr. Romaneschi joined the team in 1996 just a year after it opened, reuniting with his residency colleague Dr. Paul Manoukian. Dr. Romaneschi is highly experienced in sinus and allergy evaluation and surgery, thyroid and parathyroid surgery, and head and neck surgery. He has also been named “Best Medical Specialist” in Carson City by Nevada Appeal readers.

Alex J. Caten, M.D.

Dr. Caten was drawn to ear, nose and throat medical specialties, which offers the perfect balance of surgery and clinical medicine and enables him to have a direct impact on a patient’s everyday life. Helping people regain their senses — speech, hearing and smelling — and alleviating their suffering is powerful and rewarding work.

Heather Dean, Au.D.

Dr. Dean earned her Doctor of Audiology from the Arizona School of Health Sciences in 2005. Dr. Dean was eager for audiology-centric work that she could pour all her energy and enthusiasm into, which she found at Sierra Nevada ENT.

Madi Gurries, Au.D.

Dr. Gurries earned her bachelor's degree from the University of Nevada, Reno and then went on to complete her doctorate degree from Utah State University. She completed her externship with St. Luke's Hearing and Balance in Boise, ID before joining Sierra Nevada ENT.

Erin Burns, PA-C

Erin joined SNENT in 2016, finally able to focus on a specialty that had piqued her interest in a personal way. Her youngest brother had severe ear issues growing up and she used to help with his care. At the age of eight, she decided she wanted to work in medicine.

Kristen Wiese, PA-C

Inspired to become a Physician's Assistant while completeing her bachelor's degree, Kristen attended Yale School of Medicine's Physcian Associate program. She brings 14 years of family practice and urgent care experience to the Sierra Nevada ENT team.