Medical school: UNIVERSITY OF OKLAHOMA COLLEGE OF MEDICINE
Graduated: 1993
NPI: 1306808316
Practice Locations (1)
BOARD OF REGENTS OF THE UNIVERSITY OF OKLAHOMA OU PHYSICIANS TULSA
1111 S ST LOUIS AVE
TULSA, OK 74120
9186194400
Source: CMS National Downloadable File, September 2026.