Medical school: WAYNE STATE UNIVERSITY SCHOOL OF MEDICINE
Graduated: 2004
NPI: 1275743684
Practice Locations (1)
CHOCTAW NATION OF OKLAHOMA
902 LINCOLN RD, CHOCTAW NATIONAL HEALTH CARE IDABEL
IDABEL, OK 747457817
9185677000
Source: CMS National Downloadable File, September 2026.