Graduated: 1997
NPI: 1407850340
Practice Locations (2)
BANNER-UNIVERSITY MEDICAL GROUP
265 W INA RD
TUCSON, AZ 857046204
5206945437
BAY AREA HOSPITAL DISTRICT
1775 THOMPSON RD
COOS BAY, OR 974202125
5412698280
Source: CMS National Downloadable File, September 2026.