Medical school: KENT STATE UNIVERSITY COLLEGE OF PODIATRIC MEDICINE
Graduated: 1999
NPI: 1003899972
Practice Locations (2)
PROVIDENCE HEALTH ALLIANCE
301 RICHLAND W CIR, PROVIDENCE INTERNAL MEDICINE CLINIC
WACO, TX 767127932
2545376200
PROVIDENCE HEALTH ALLIANCE
6901 MEDICAL PKWY
WACO, TX 767127910
2547514000
Source: CMS National Downloadable File, September 2026.