Medical school: UNIVERSITY OF ILLINOIS COLLEGE OF MED (CHI/PEOR/ROCK/CHM-URB)
Graduated: 2021
NPI: 1962084723
Practice Locations (1)
FORT HEALTHCARE INC
611 SHERMAN AVE E
FORT ATKINSON, WI 535381960
9205681000
Source: CMS National Downloadable File, September 2026.