Medical school: WRIGHT STATE UNIVERSITY BOONSHOFT SCHOOL OF MEDICINE
Graduated: 1991
NPI: 1366415234
Practice Locations (1)
INTEGRIS AMBULATORY CARE CORPORATION
310 2ND AVE SW, 208 INTEGRIS SRGNS CLIN
MIAMI, OK 743546702
9185407870
Source: CMS National Downloadable File, September 2026.