Medical school: UNIVERSITY OF ILLINOIS COLLEGE OF MED (CHI/PEOR/ROCK/CHM-URB)
Graduated: 1975
NPI: 1467509505
Practice Locations (1)
OHI WEST MEDICAL GROUP LLC
700 6TH ST S, FL 2
ST PETERSBURG, FL 337014815
7278936198
Source: CMS National Downloadable File, September 2026.