Medical school: HAHNEMANN UNIVERSITY COLLEGE OF MEDICINE
Graduated: 1977
NPI: 1477550572
Practice Locations (1)
PROVIDENCE HEALTH AND SERVICES - WASHINGTON
1017 S 2ND AVE, SUITE 3
WALLA WALLA, WA 993624183
5098978200
Source: CMS National Downloadable File, September 2026.