Medical school: UNIVERSITY OF MINNESOTA MEDICAL SCHOOL
Graduated: 2004
NPI: 1043410418
Practice Locations (2)
DHEW IND HLTH SV HLTH SVS AND MNTL HLTH ADM
4212 N 16TH ST
PHOENIX, AZ 850165319
6022631200
SIERRA VISTA REGIONAL HEALTH CENTER MEDICAL GROUP LLC
5750 E HWY 90, SUITE 150
SIERRA VISTA, AZ 856359115
5202633770
Source: CMS National Downloadable File, September 2026.