Medical school: UNIVERSITY OF OKLAHOMA COLLEGE OF MEDICINE
Graduated: 1996
NPI: 1295710846
Practice Locations (2)
1800 RENAISSANCE BLVD
EDMOND, OK 730133023
4053592400
3840 S BOULEVARD, SUITE 103
EDMOND, OK 730135888
4054553937
Source: CMS National Downloadable File, September 2026.