Medical school: UNIVERSITY OF ILLINOIS COLLEGE OF MED (CHI/PEOR/ROCK/CHM-URB)
Graduated: 2000
NPI: 1538238803
Practice Locations (1)
COLUMBIA LUTHERAN CHARITIES
1905 EXCHANGE ST
ASTORIA, OR 97103
5033384085
Source: CMS National Downloadable File, September 2026.