Graduated: 1989
NPI: 1962439315
Practice Locations (2)
STATE OF ALASKA DEPARTMENT OF ADMINISTRATION
3700 PIPER ST
ANCHORAGE, AK 995084665
9072697100
PRACTICE ASSOCIATES MEDICAL GROUP
175 HIGH ST
NEWTON, NJ 078601004
9733832121
Source: CMS National Downloadable File, September 2026.