Medical school: PONCE SCHOOL OF MEDICINE
Graduated: 1999
NPI: 1629061213
Practice Locations (1)
INTEGRIS AMBULATORY CARE CORPORATION
900 E 13TH ST, 205 INTEGRIS GRAND LAKE OB/GYN
GROVE, OK 743442981
9187862720
Source: CMS National Downloadable File, September 2026.