Medical school: WRIGHT STATE UNIVERSITY BOONSHOFT SCHOOL OF MEDICINE
Graduated: 1998
Offers telehealth
NPI: 1740232735
Practice Locations (1)
PORTAGE SURGICAL ASSOCIATES INC
3973 LOOMIS PKWY, SUITE A
RAVENNA, OH 442661803
3302968239
Source: CMS National Downloadable File, September 2026.