Medical school: INDIANA UNIVERSITY SCHOOL OF MEDICINE
Graduated: 1984
NPI: 1891750089
Practice Locations (2)
1234 E DUPONT RD, SUITE 1
FORT WAYNE, IN 468251545
1234 E DUPONT RD, SUITE 1
FORT WAYNE, IN 554856484
Source: CMS National Downloadable File, September 2026.