Medical school: UNIVERSITY OF ILLINOIS COLLEGE OF MED (CHI/PEOR/ROCK/CHM-URB)
Graduated: 1990
NPI: 1356400618
Practice Locations (2)
PROVIDENCE HEALTH AND SERVICES OREGON
840 ROYAL AVE
MEDFORD, OR 975046461
5417328370
PROVIDENCE HEALTH AND SERVICES OREGON
940 ROYAL AVE
MEDFORD, OR 975046194
Source: CMS National Downloadable File, September 2026.