Medical school: ILLINOIS COLLEGE OF OPTOMETRY AT CHICAGO
Graduated: 2025
NPI: 1679459960
Practice Locations (2)
3456 FAIRLANE DR, UNIT 104
ALLEN PARK, MI 481012873
19100 RIDGEWOOD PKWY, FL 7
SAN ANTONIO, TX 782591828
Source: CMS National Downloadable File, September 2026.