Medical school: MICHIGAN STATE UNIVERSITY COLLEGE OF OSTEOPATHIC MEDICINE
Graduated: 1986
NPI: 1154356277
Practice Locations (1)
OPTUMCARE NEW MEXICO LLC
5150 JOURNAL CTR BLVD NE, FL 3
ALBUQUERQUE, NM 871095900
5052627000
Source: CMS National Downloadable File, September 2026.