-
Gender
Male
Board certifications
American Osteopathic Board of Family Physicians
Licenses
AZ, FM7527988
Employed or contracted
Contracted
Network Name
OptumCare Network of Nevada
PCP ID
UHC HMO & D-SNP ID - 00010011527, UHC PPO ID - 00010529379, Humana ID - Not Participating
NPI
1396123915
Hospital affiliations
Kingman Regional Medical Center
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