Graduated: 2016
NPI: 1790148005
Practice Locations (2)
BANNER - UNIVERSITY HOSPITAL BASED PHYSICIANS LLC
1111 E MCDOWELL RD
PHOENIX, AZ 850062612
6028392000
ST ALPHONSUS PROFESSIONAL MEDICAL SERVICES LLC
1055 N CURTIS RD
BOISE, ID 837061309
2083672152
Source: CMS National Downloadable File, September 2026.