Medical school: ARIZONA COLLEGE OF OSTEOPATHIC MEDICINE MID WESTERN UNIVERSITY
Graduated: 2007
NPI: 1720303662
Practice Locations (1)
LICKING MEMORIAL PROFESSIONAL CORPORATION
1320 W MAIN ST, LICKING MEMORIAL PATHOLOGY
NEWARK, OH 430551822
2205644266
Source: CMS National Downloadable File, September 2026.