Medical school: NOVA SOUTHEASTERN COLLEGE OF OSTEO MEDICINE
Graduated: 2020
NPI: 1255894572
Practice Locations (1)
DHHS PHS NAIHS CHINLE COMPREHENSIVE HEALTH CARE FACILITY
HIGHWAY 191 AND HOSPITAL RD
CHINLE, AZ 865038000
92867470307030
Source: CMS National Downloadable File, September 2026.