Medical school: UNIVERSITY OF CINCINNATI COLLEGE OF MEDICINE
Graduated: 1992
NPI: 1962541060
Practice Locations (3)
1919 NW LOVEJOY ST
Portland, OR 972091503
1919 NW LOVEJOY ST
PORTLAND, OR 972091503
2850 NW 31ST AVE
PORTLAND, OR 972101720
Source: CMS National Downloadable File, September 2026.