Medical school: RUTGERS R W JOHNSON MEDICAL SCHOOL (CAM/NEW BRUNS/PISC)
Graduated: 1985
NPI: 1043259500
Practice Locations (1)
WAKE FOREST UNIVERSITY HEALTH SCIENCES
MEDICAL CTR BLVD
WINSTON SALEM, NC 271570001
3367162734
Source: CMS National Downloadable File, September 2026.