Medical school: UNIVERSITY OF ILLINOIS COLLEGE OF MED (CHI/PEOR/ROCK/CHM-URB)
Graduated: 1973
NPI: 1083784508
Practice Locations (1)
3524 NW 56TH ST, SELECT SPECIALTY HOSPITAL OKLAHOMA
OKLAHOMA CITY, OK 731124518
4056066700
Source: CMS National Downloadable File, September 2026.