Medical school: WEST VIRGINIA UNIVERSITY SCHOOL OF MEDICINE
Graduated: 1991
NPI: 1962462739
Practice Locations (2)
468 W 23RD ST
NEW YORK, NY 100112175
468 W 23RD ST, APT 1A
NEW YORK, NY 100112175
9178410593
Source: CMS National Downloadable File, September 2026.