Medical school: UNIVERSITY OF TEXAS MEDICAL BRANCH AT GALVESTON
Graduated: 2017
NPI: 1891228607
Practice Locations (1)
HUMAN SERVICES BOARD SERVING NORTH CENTRAL HEALTH CARE FACILITY
2400 MARSHALL ST, SUITE A
WAUSAU, WI 544036738
7158484600
Source: CMS National Downloadable File, September 2026.