Medical school: UNIVERSITY OF WISCONSIN SCHOOL OF MEDICINE
Graduated: 1995
NPI: 1578564357
Practice Locations (2)
MAINEHEALTH
108 CENTRE ST
BATH, ME 045302550
MAINEHEALTH
22 BRAMHALL ST
PORTLAND, ME 041023134
2078859905
Source: CMS National Downloadable File, September 2026.