Medical school: UNIVERSITY OF ILLINOIS COLLEGE OF MED (CHI/PEOR/ROCK/CHM-URB)
Graduated: 1995
NPI: 1790757177
Practice Locations (1)
PUBLIC HOSPITAL DIST NO 1 SKAGIT
1415 E KINCAID ST
MOUNT VERNON, WA 982744126
3604165750
Source: CMS National Downloadable File, September 2026.