Graduated: 1987
NPI: 1508842600
Practice Locations (2)
DAYTON OSTEOPATHIC HOSPITAL
1989 MIAMISBURG CENTERVILLE RD, SUITE 204
DAYTON, OH 45342
9373846822
KETTERING INDEPENDENT MEDICAL GROUP INC
3535 SOUTHERN BLVD
KETTERING, OH 454291221
9373958056
Source: CMS National Downloadable File, September 2026.