Medical school: OKLAHOMA STATE UNIVERSITY COLLEGE OF OSTEOPATHIC MEDICINE
Graduated: 2003
NPI: 1578665063
Practice Locations (1)
INTEGRIS AMBULATORY CARE CORPORATION
5401 N PORTLAND AVE, SUITE 600
OKLAHOMA CITY, OK 731122121
4057139940
Source: CMS National Downloadable File, September 2026.