Graduated: 2008
NPI: 1962655506
Practice Locations (2)
BANNER-UNIVERSITY MEDICAL GROUP
1625 N CAMPBELL AVE
TUCSON, AZ 857194330
5206940111
ST ALPHONSUS PROFESSIONAL MEDICAL SERVICES LLC
1055 N CURTIS RD
BOISE, ID 837061309
2083672152
Source: CMS National Downloadable File, September 2026.