Medical school: UNIVERSITY OF SOUTH FLORIDA COLLEGE OF MEDICINE
Graduated: 1998
NPI: 1831200260
Practice Locations (1)
DHEW IND HLTH SV HLTH SVS AND MNTL HLTH ADM
4212 N 16TH ST
PHOENIX, AZ 850165319
6022631200
Source: CMS National Downloadable File, September 2026.