Graduated: 2017
NPI: 1487185633
Practice Locations (4)
PO BOX
LEWISTON, ME 04243
144 GENESEE ST
BUFFALO, NY 142031560
144 GENESEE ST, FL 3
BUFFALO, NY 142031510
200 W MARTIN LUTHER KING BLVD, SUITE 1000
Chattanooga, TN 374022571
Source: CMS National Downloadable File, September 2026.