Medical school: UNIVERSITY OF NEW MEXICO SCHOOL OF MEDICINE
Graduated: 1995
NPI: 1811081458
Practice Locations (2)
MAINEHEALTH
1577 CONGRESS ST
PORTLAND, ME 041022169
MAINEHEALTH
22 BRAMHALL ST
PORTLAND, ME 041023134
2078859905
Source: CMS National Downloadable File, September 2026.