Medical school: UNIVERSITY OF ILLINOIS COLLEGE OF MED (CHI/PEOR/ROCK/CHM-URB)
Graduated: 1977
NPI: 1932102613
Practice Locations (1)
GREEN BAY PLASTIC SURGICAL ASSOC
704 S WEBSTER AVE SU, SUITE 401
GREEN BAY, WI 543013531
9204327000
Source: CMS National Downloadable File, September 2026.