Medical school: UNIVERSITY OF ILLINOIS COLLEGE OF MED (CHI/PEOR/ROCK/CHM-URB)
Graduated: 1999
NPI: 1144333501
Practice Locations (1)
VITUITY-WISCONSIN EM SC
835 S VAN BUREN ST
GREEN BAY, WI 543013526
9204330111
Source: CMS National Downloadable File, September 2026.