Medical school: MEDICAL COLLEGE OF WISCONSIN
Graduated: 1968
NPI: 1437133816
Practice Locations (2)
WAKE FOREST UNIVERSITY HEALTH SCIENCES
131 MILLER ST
WINSTON SALEM, NC 271032508
3367162734
WAKE FOREST UNIVERSITY HEALTH SCIENCES
MEDICAL CTR BLVD
WINSTON SALEM, NC 271570001
3367162734
Source: CMS National Downloadable File, September 2026.