Medical school: WRIGHT STATE UNIVERSITY BOONSHOFT SCHOOL OF MEDICINE
Graduated: 1996
NPI: 1104848423
Practice Locations (2)
15 EXECUTIVE DR
LAFAYETTE, IN 479054868
7658383428
810 S 6TH ST B, IU WHITE COUNTY MEMORIAL HOSPITAL
MONTICELLO, IN 479608201
5745835200
Source: CMS National Downloadable File, September 2026.