Graduated: 1998
NPI: 1124478193
Practice Locations (2)
CIBOLA GENERAL HOSPITAL CORPORATION
1016 E ROOSEVELT AVE
GRANTS, NM 870202118
CIBOLA GENERAL HOSPITAL CORPORATION
1423 E ROOSEVELT AVE, CIBOLA GENERAL HOSPITAL
GRANTS, NM 870202118
5052876500
Source: CMS National Downloadable File, September 2026.