Medical school: MEDICAL COLLEGE OF WISCONSIN
Graduated: 1975
NPI: 1053399568
Practice Locations (2)
KINGMAN HEALTHCARE INC
3269 N STOCKTON HILL RD
KINGMAN, AZ 864093619
9287572101
SJHMC PHYSICIAN SERVICES
625 N 6TH ST
PHOENIX, AZ 850042155
6024068222
Source: CMS National Downloadable File, September 2026.