Graduated: 2022
NPI: 1790355949
Practice Locations (2)
DHHS,PHS,NAIHS, GALLUP INDIAN MEDICAL CENTER
516 E NIZHONI BLVD
GALLUP, NM 873015748
5057221000
MAIN STREET ANESTHESIA OF NEW MEXICO, LLC
117 E 19TH ST, LOVELACE REGIONAL HOSPITAL ROSWELL
ROSWELL, NM 882015151
5756277000
Source: CMS National Downloadable File, September 2026.