Medical school: WAYNE STATE UNIVERSITY SCHOOL OF MEDICINE
Graduated: 1982
NPI: 1124131255
Practice Locations (2)
U S HEALTH DEPT OF HEALTH AND HUMAN SERVICES
10110 S 7650
CROE AGENCY, MT 590220009
4066384616
U S HEALTH DEPT OF HEALTH AND HUMAN SERVICES
10110 S 7650, P.O. BOX 9
CROE AGENCY, MT 590220009
Source: CMS National Downloadable File, September 2026.