Medical school: STATE UNIVERSITY OF NY UPSTATE MEDICAL UNIVERSITY
Graduated: 1988
NPI: 1366534570
Practice Locations (2)
PO BOX, SUITE 94390
ALBUQUERQUE, NM 87199
PO BOX, SUITE 94390
ALBUQUERQUE, NM 871994390
Source: CMS National Downloadable File, September 2026.