Medical school: TUFTS UNIVERSITY SCHOOL OF MEDICINE
Graduated: 1985
NPI: 1215930391
Practice Locations (2)
N74W12501 LEATHERWOOD CT
MENOMONEE FALLS, WI 53051
N74W12501 LEATHERWOOD CT
MENOMONEE FALLS, WI 530514490
Source: CMS National Downloadable File, September 2026.