Graduated: 2016
NPI: 1780980920
Practice Locations (3)
1920 W POTOMAC AVE
CHICAGO, IL 606223149
5710 OLEANDER DR, SUITE 211
Wilmington, NC 284034722
5710 OLEANDER DR, SUITE 211
WILMINGTON, NC 284034766
Source: CMS National Downloadable File, September 2026.