Graduated: 1990
NPI: 1467485276
Practice Locations (3)
11109 PARKVIEW PLAZA DR, SUITE 117
Fort Wayne, IN 468451701
11109 PARKVIEW PLAZA DR, SUITE 117
FORT WAYNE, IN 468451701
6920 POINTE INVERNESS WAY, SUITE 200
FORT WAYNE, IN 468047934
Source: CMS National Downloadable File, September 2026.