Medical school: UNIVERSITY OF ROCHESTER SCHOOL OF MEDICINE AND DENTISTRY
Graduated: 1995
NPI: 1801864293
Practice Locations (5)
PO BOX, SUITE 741658
LOS ANGELES, CA 90074
15770 CEDAR GROVE LN
Wellington, FL 334146311
15770 CEDAR GROVE LN
WELLINGTON, FL 334146311
6742 N FROSTWOOD PKWY
PEORIA, IL 616152402
4100 INTERNATIONAL PLZ
FORT WORTH, TX 761094800
Source: CMS National Downloadable File, September 2026.