Medical school: WEST VIRGINIA SCHOOL OF OSTEOPATHIC MEDICINE
Graduated: 1995
NPI: 1326018557
Practice Locations (1)
GILA RIVER HEALTH CARE CORPORATION
17487 S HEALTH CARE DR, HU HU KAM MEMORIAL HOSPITAL
LAVEEN, AZ 853390038
5205506000
Source: CMS National Downloadable File, September 2026.