Medical school: MICHIGAN STATE UNIVERSITY COLLEGE OF OSTEOPATHIC MEDICINE
Graduated: 1995
Also: GENERAL SURGERY, INTERNAL MEDICINE
NPI: 1073596243
Practice Locations (1)
LEGACY CLINICS LLC
25050 SE STARK ST
GRESHAM, OR 970303383
5036741848
Source: CMS National Downloadable File, September 2026.