Medical school: UNIVERSITY OF CALIFORNIA, DAVIS SCHOOL OF MEDICINE
Graduated: 2005
NPI: 1013020809
Practice Locations (2)
1200 N BEAVER ST
FLAGSTAFF, AZ 860013118
1200 N BEAVER ST, ATTN PAYER CREDENTIALING
FLAGSTAFF, AZ 860013118
Source: CMS National Downloadable File, September 2026.