Medical school: UNIVERSITY OF NEBRASKA COLLEGE OF MEDICINE
Graduated: 1993
NPI: 1851339121
Practice Locations (2)
503 OREGON ST
HIAWATHA, KS 664342221
7857424100
STATE OF MISSOURI
3505 FREDERICK AVE
SAINT JOSEPH, MO 645062914
8163872300
Source: CMS National Downloadable File, September 2026.