Graduated: 2016
NPI: 1407215460
Practice Locations (2)
NORTHEASTERN HEALTH SYSTEM
1400 E DOWNING ST
TAHLEQUAH, OK 744643324
9184560641
OKLAHOMA STATE UNIVERSITY
2345 SOUTHWEST BLVD
TULSA, OK 741072705
9185615701
Source: CMS National Downloadable File, September 2026.