Medical school: UNIVERSITY OF ILLINOIS COLLEGE OF MED (CHI/PEOR/ROCK/CHM-URB)
Graduated: 1995
NPI: 1528077419
Practice Locations (2)
44000 GARFIELD RD
CLINTON TOWNSHIP, MI 544014102
333 PINE RIDGE BLVD
WAUSAU, WI 544014187
Source: CMS National Downloadable File, September 2026.