Medical school: MIDWESTERN UNIVERSITY, CHICAGO COLLEGE OF OSTEOPATHIC MED
Graduated: 1987
NPI: 1215044540
Practice Locations (1)
SAN JUAN REGIONAL MEDICAL CENTER, INC.
801 W MAPLE ST, SJRMC ER PHYSICIANS
FARMINGTON, NM 874015630
5056092000
Source: CMS National Downloadable File, September 2026.