Medical school: UNIVERSITY OF MISSOURI, COLUMBIA SCHOOL OF MEDICINE
Graduated: 2002
Offers telehealth
NPI: 1265419006
Practice Locations (1)
NORTHWESTERN MEDICAL FACULTY FOUNDATION
675 N ST CLAIR, 150 DEPT OF UROLOGY
CHICAGO, IL 606115975
3126958900
Source: CMS National Downloadable File, September 2026.