Medical school: UNIVERSITY OF MISSOURI, COLUMBIA SCHOOL OF MEDICINE
Graduated: 1998
Also: PEDIATRIC MEDICINE
NPI: 1700835204
Practice Locations (2)
10689 N PENNSYLVANIA ST, 200 INDIANA PAYER CONTRACTING
INDIANAPOLIS, IN 462801099
250 N SHADELAND AVE 130 PROVIDER ENROLLME
INDIANAPOLIS, IN 462194959
Source: CMS National Downloadable File, September 2026.