Graduated: 1983
NPI: 1821082256
Practice Locations (2)
BANNER HOSPITAL BASED PHYSICIANS ARIZONA LLC
5555 W THUNDERBIRD RD
GLENDALE, AZ 853064622
6028655555
BANNER HOSPITAL BASED PHYSICIANS ARIZONA LLC
1111 E MCDOWELL RD
PHOENIX, AZ 850062612
6028392000
Source: CMS National Downloadable File, September 2026.