Medical school: PHILADELPHIA COLLEGE OF OSTEOPATHIC MEDICINE
Graduated: 1993
NPI: 1114011889
Practice Locations (1)
DHEW IND HLTH SV HLTH SVS AND MNTL HLTH ADM
48203 W FARRELL RD, AK CHIN CLINIC
MARICOPA, AZ 851393806
5205683881
Source: CMS National Downloadable File, September 2026.