Medical school: RUTGERS NEW JERSEY MEDICAL SCHOOL
Graduated: 1995
NPI: 1366427650
Practice Locations (1)
DHHS,PHS,NAIHS, GALLUP INDIAN MEDICAL CENTER
516 E NIZHONI BLVD
GALLUP, NM 873015748
5057221000
Source: CMS National Downloadable File, September 2026.