Medical school: JOHNS HOPKINS UNIVERSITY SCHOOL OF MEDICINE
Graduated: 1994
NPI: 1013087451
Practice Locations (2)
PO BOX, SUITE 16950
MESA, AZ 852116950
1501 N CAMPBELL AVE, CONTRACTS DEPT 245575
TUCSON, AZ 857245575
Source: CMS National Downloadable File, September 2026.