Medical school: WEST VIRGINIA UNIVERSITY SCHOOL OF MEDICINE
Graduated: 2021
NPI: 1033785803
Practice Locations (2)
PO BOX, SUITE 649
FORT DEFIANCE, AZ 86504
79 RAINES LN
KENNA, WV 252487704
Source: CMS National Downloadable File, September 2026.
This site republishes official CMS/Medicare Care Compare data. It is not medical advice and does not recommend any specific hospital or treatment — for medical decisions, talk to a doctor.
Medical school: WEST VIRGINIA UNIVERSITY SCHOOL OF MEDICINE
Graduated: 2021
NPI: 1033785803
PO BOX, SUITE 649
FORT DEFIANCE, AZ 86504
79 RAINES LN
KENNA, WV 252487704
Source: CMS National Downloadable File, September 2026.