Medical school: UNIVERSITY OF KANSAS SCHOOL OF MED (KC/WICH/SAL)
Graduated: 1998
NPI: 1134163405
Practice Locations (1)
BANNER HOSPITAL BASED PHYSICIANS ARIZONA LLC
1400 S DOBSON RD
MESA, AZ 852024707
4804123000
Source: CMS National Downloadable File, September 2026.