Medical school: WAKE FOREST UNIVERSITY SCHOOL OF MEDICINE
Graduated: 1986
NPI: 1356346209
Practice Locations (1)
LA CLINICA DE FAMILIA INCORPORATED
18420 S HWY 28, LCDF SAN MIGUEL MEDICAL
LA MESA, NM 880449605
5752333830
Source: CMS National Downloadable File, September 2026.