Medical school: CLVLND CLINIC LERNER COLLEGE OF MED OF CASE WSTN RSV UNIVERSITY
Graduated: 1999
NPI: 1710085659
Practice Locations (1)
STATE OF OHIO OFFICE OF BUDGET AND MANAGEMENT STATE ACCOUNTING
1756 SAGAMORE RD
NORTHFIELD, OH 440671086
3308333135
Source: CMS National Downloadable File, September 2026.