Medical school: ILLINOIS COLLEGE OF OPTOMETRY AT CHICAGO
Graduated: 1999
NPI: 1417939604
Practice Locations (2)
10730 A ENDURING FREEDOM DR, BLDG P
FORT DRUM, NY 136025405
3154058671
10730 A ENDURING FREEDOM DR A
FORT DRUM, NY 136025405
Source: CMS National Downloadable File, September 2026.