Medical school: CLVLND CLINIC LERNER COLLEGE OF MED OF CASE WSTN RSV UNIVERSITY
Graduated: 1996
NPI: 1477532364
Practice Locations (1)
FOUNDATION FOR OUTREACH SERVICES
326 W 64TH ST
CHICAGO, IL 606213114
7739623900
Source: CMS National Downloadable File, September 2026.