Medical school: UNIVERSITY OF MARYLAND SCHOOL OF MEDICINE
Graduated: 1994
NPI: 1679513402
Practice Locations (2)
MAINEHEALTH
329 MAINE ST
BRUNSWICK, ME 040113310
MAINEHEALTH
22 BRAMHALL ST
PORTLAND, ME 041023134
2078859905
Source: CMS National Downloadable File, September 2026.