Medical school: UNIVERSITY OF ILLINOIS COLLEGE OF MED (CHI/PEOR/ROCK/CHM-URB)
Graduated: 1980
NPI: 1265437404
Practice Locations (1)
PRIVIA MEDICAL GROUP INDIANA LLC
2222 W LEXINGTON AVE, SUITE A
ELKHART, IN 465141420
5742943030
Source: CMS National Downloadable File, September 2026.