Graduated: 1976
NPI: 1740836659
Practice Locations (3)
223 MAYFAIR BLVD APT D
Columbus, OH 432132212
6151 WILSON MILLS RD, SUITE 308
Highland Heights, OH 441432128
6151 WILSON MILLS RD, SUITE 308
HIGHLAND HEIGHTS, OH 441432128
Source: CMS National Downloadable File, September 2026.