Medical school: ILLINOIS COLLEGE OF OPTOMETRY AT CHICAGO
Graduated: 2011
NPI: 1063709491
Practice Locations (2)
WATERTOWN PHYSICIAN PRACTICES LLC
123 HOSPITAL DR
WATERTOWN, WI 530983320
WATERTOWN PHYSICIAN PRACTICES LLC
1507 DOCTORS CT
WATERTOWN, WI 530944101
9202614111
Source: CMS National Downloadable File, September 2026.