Medical school: OHIO STATE UNIVERSITY COLLEGE OF MEDICINE
Graduated: 1988
NPI: 1427040567
Practice Locations (2)
119 PROFESSIONAL CTR, 1265 WAYNE AVENUE SUITE 203
Indiana, PA 157013501
1265 WAYNE AVE, 119 PROFESSIONAL CENTER SUITE 203
INDIANA, PA 157013586
7244630286
Source: CMS National Downloadable File, September 2026.