Medical school: UNIVERSITY OF UTAH SCHOOL OF MEDICINE
Graduated: 1973
NPI: 1205883238
Practice Locations (3)
1554 PO BOX
STONY BROOK, NY 117900988
PO BOX, SUITE 1554
STONY BROOK, NY 11790
PO BOX, SUITE 1554
STONY BROOK, NY 117900988
Source: CMS National Downloadable File, September 2026.