Medical school: UNIVERSITY OF TEXAS SOUTHWESTERN MEDICAL SCHOOL AT DALLAS
Graduated: 1993
NPI: 1003830399
Practice Locations (2)
2418 LAKE AVE
FORT WAYNE, IN 468055406
2609189450
OWENSBORO HEALTH MEDICAL GROUP INC
1301 PLEASANT VALLEY RD, SUITE 300
OWENSBORO, KY 423039774
2704177700
Source: CMS National Downloadable File, September 2026.