Medical school: UNIVERSITY OF ILLINOIS COLLEGE OF MED (CHI/PEOR/ROCK/CHM-URB)
Graduated: 1995
NPI: 1063527349
Practice Locations (1)
DIVINE SAVIOR HEALTHCARE INC
2817 NEW PINERY RD
PORTAGE, WI 539019240
6087424131
Source: CMS National Downloadable File, September 2026.