Medical school: UNIVERSITY OF ILLINOIS COLLEGE OF MED (CHI/PEOR/ROCK/CHM-URB)
Graduated: 2025
NPI: 1366199978
Practice Locations (2)
1 ZOTEC WAY
CARMEL, IN 460320052
PO BOX, SUITE 26974
SALT LAKE CITY, UT 84126
Source: CMS National Downloadable File, September 2026.