Graduated: 2000
NPI: 1447314166
Practice Locations (2)
DHHS IHS PHOENIX AREA
HIGHWAY 264 MILEPOST, SUITE 388
POLACCA, AZ 860424000
DHHS IHS PHOENIX AREA
PO BOX, 4000 HWY 264 MILEPOST 388
POLACCA, AZ 860424000
Source: CMS National Downloadable File, September 2026.