Medical school: LOUISIANA STATE UNIVERSITY SCHOOL OF MEDICINE IN SHREVEPORT
Graduated: 2020
NPI: 1598393027
Practice Locations (2)
FORT HEALTHCARE INC
611 SHERMAN AVE E
FORT ATKINSON, WI 535381960
9205681000
UNIVERSITY OF WISCONSIN MEDICAL FOUNDATION INC
600 HIGHLAND AVE
MADISON, WI 537920001
6082636400
Source: CMS National Downloadable File, September 2026.