National Provider Identifier (NPI):
1811949712
License Number:
036-071422
Medical School:
Chicago Coll Of Osteo Med, Midwestern Univ, Chicago IL 60615
Residency Training:
Univ Il Coll Of Med, Urology; Univ Il Coll Of Med, General Surgery; Chicago Osteo Hosps & M C, Flexible Or Transitional Year