Medical school: OKLAHOMA STATE UNIVERSITY COLLEGE OF OSTEOPATHIC MEDICINE
Graduated: 2022
NPI: 1194395582
Practice Locations (1)
DHEW IND HLTH SV HLTH SVS AND MNTL HLTH ADM
4212 N 16TH ST
PHOENIX, AZ 850165319
6022631200
Source: CMS National Downloadable File, September 2026.