Medical school: MIDWESTERN UNIVERSITY COLLEGE OF DENTAL MEDICINE, GLENDALE
Graduated: 1996
NPI: 1407891633
Practice Locations (1)
ENDEAVOR HEALTH MEDICAL GROUP
2650 RIDGE AVE, SUITE 2218A
EVANSTON, IL 602011700
8475034222
Source: CMS National Downloadable File, September 2026.