Medical school: PACIFIC NW UN OF HS, COL OF OSTEOPATHIC MEDICINE
Graduated: 2020
NPI: 1164042297
Practice Locations (2)
4212 N 16TH ST
PHOENIX, AZ 850165319
PO BOX, SUITE 95460
CLEVELAND, OH 44101
Source: CMS National Downloadable File, September 2026.