Medical school: MEDICAL COLLEGE OF WISCONSIN
Graduated: 2023
NPI: 1902509565
Practice Locations (4)
1919 NW LOVEJOY ST
PORTLAND, OR 972091503
2850 NW 31ST AVE
PORTLAND, OR 972101720
400 W RIVER WOODS PKWY
Glendale, WI 532121060
400 W RIVER WOODS PKWY
GLENDALE, WI 532121060
Source: CMS National Downloadable File, September 2026.