Graduated: 2013
NPI: 1164853735
Practice Locations (2)
MOUNT CARMEL HEALTH SYSTEM
6001 E BROAD ST
COLUMBUS, OH 432131502
6142346000
LICKING MEMORIAL PROFESSIONAL CORPORATION
1320 W MAIN ST
NEWARK, OH 430551822
2205644137
Source: CMS National Downloadable File, September 2026.