Medical school: INDIANA UNIVERSITY SCHOOL OF MEDICINE
Graduated: 2023
NPI: 1972206308
Practice Locations (2)
3200 BURNET AVE, PAYOR ENROLLMENT 2 RIDGEWAY
Cincinnati, OH 452293019
3200 BURNET AVE
CINCINNATI, OH 452293028
Source: CMS National Downloadable File, September 2026.