Medical school: UNIVERSITY OF TEXAS SOUTHWESTERN MEDICAL SCHOOL AT DALLAS
Graduated: 1973
NPI: 1346210994
Practice Locations (1)
CENTENNIAL MEDICAL GROUP INC
2510 NW EDENBOWER BLVD, SUITE 112
ROSEBURG, OR 974718899
5415414646
Source: CMS National Downloadable File, September 2026.