Medical school: UNIVERSITY OF MINNESOTA MEDICAL SCHOOL
Graduated: 1989
NPI: 1871558833
Practice Locations (3)
331 NEWMAN SPRINGS RD BLDG, 2 SUITE 220
RED BANK, NJ 077015688
17 LANSING ST
AUBURN, NY 130211943
17 LANSING ST
AUBURN, NY 130211983
Source: CMS National Downloadable File, September 2026.