Medical school: UNIVERSITY OF TEXAS MEDICAL SCHOOL AT HOUSTON
Graduated: 2013
NPI: 1356788756
Practice Locations (1)
DHS OFFICE OF FINANCIAL SERVICES IRS EOPC BMRC EOTC OSH OSH-P
2600 CTR ST NE
SALEM, OR 973012669
5039452800
Source: CMS National Downloadable File, September 2026.