Medical school: UNIVERSITY OF MISSOURI, COLUMBIA SCHOOL OF MEDICINE
Graduated: 2020
NPI: 1144858705
Practice Locations (2)
DHHS PHS NAIHS CHINLE COMPREHENSIVE HEALTH CARE FACILITY
HIGHWAY 191 AND HOSPITAL RD
CHINLE, AZ 865038000
92867470307030
REGENTS OF THE UNIV OF CA
2315 STOCKTON BLVD
SACRAMENTO, CA 958172201
9167033011
Source: CMS National Downloadable File, September 2026.