Graduated: 1998
NPI: 1326098013
Practice Locations (2)
LEE HEALTH SYSTEM INC
9800 S HEALTHPARK DR, SUITE 110
FORT MYERS, FL 339083630
2393436202
PRIVIA MEDICAL GROUP INDIANA LLC
303 N NAPPANEE ST
ELKHART, IN 465142066
57429632003973
Source: CMS National Downloadable File, September 2026.