Medical school: OKLAHOMA STATE UNIVERSITY COLLEGE OF OSTEOPATHIC MEDICINE
Graduated: 1990
NPI: 1598818395
Practice Locations (1)
NORTHWESTERN MEDICAL FACULTY FOUNDATION
1000 WESTMORELAND RD, PAVILLION B 1ST FL
LAKE FOREST, IL 600451659
8472345600
Source: CMS National Downloadable File, September 2026.