Medical school: UNIVERSITY OF ILLINOIS COLLEGE OF MED (CHI/PEOR/ROCK/CHM-URB)
Graduated: 1987
NPI: 1801074604
Practice Locations (1)
BOARD OF REGENTS OF THE UNIVERSITY SYSTEM OF GEORGIA
55 CARLTON ST
ATHENS, GA 306021755
7065428621
Source: CMS National Downloadable File, September 2026.