Medical school: RUSH MEDICAL COLLEGE OF RUSH UNIVERSITY
Graduated: 1988
NPI: 1003873894
Practice Locations (2)
14 DOCTORS CIR, SUITE 4
SUPPLY, NC 284624088
9107545434
1115 48TH AVE N, SUITE 121
MYRTLE BEACH, SC 295775420
8434496478
Source: CMS National Downloadable File, September 2026.