Graduated: 1982
NPI: 1902822802
Practice Locations (2)
TRIAD PEDIATRICS, LLC
1001 HOSPITAL CIR
KINGFISHER, OK 737505002
4053757935
PROPHYLAXIS HEALTHCARE LLC
220 W 71ST ST, SUITE 2
TULSA, OK 741322011
9189702886
Source: CMS National Downloadable File, September 2026.