Medical school: NEW YORK COLLEGE OF PODIATRIC MEDICINE
Graduated: 2007
NPI: 1215112545
Practice Locations (2)
DHEW IND HLTH SV HLTH SVS AND MNTL HLTH ADM
4212 N 16TH ST
PHOENIX, AZ 850165319
6022631200
DHHS PHS IHS PHOENIX AREA
401 PICACHO RD
WINTERHAVEN, CA 922839605
7605724137
Source: CMS National Downloadable File, September 2026.