Medical school: UNIVERSITY OF ILLINOIS COLLEGE OF MED (CHI/PEOR/ROCK/CHM-URB)
Graduated: 1998
Offers telehealth
NPI: 1184692568
Practice Locations (1)
LAKE REGIONAL HEALTH SYSTEM
54 HOSPITAL DR
OSAGE BEACH, MO 650653050
5733488045
Source: CMS National Downloadable File, September 2026.