Medical school: MEDICAL COLLEGE OF WISCONSIN
Graduated: 1993
NPI: 1922082122
Practice Locations (2)
KETAMINE MILWAUKEE SC
10424 W BLUEMOUND RD
MILWAUKEE, WI 532264331
4142061606
ANEX, S.C.
725 S AMERICAN AVE
WAUKESHA, WI 531885301
2625442011
Source: CMS National Downloadable File, September 2026.