Medical school: RUSH MEDICAL COLLEGE OF RUSH UNIVERSITY
Graduated: 2020
NPI: 1942818398
Practice Locations (2)
1200 N BEAVER ST
FLAGSTAFF, AZ 860013118
1200 N BEAVER ST, ATTN PAYOR CREDENTIALING
FLAGSTAFF, AZ 860013118
Source: CMS National Downloadable File, September 2026.