Medical school: UNIVERSITY OF ILLINOIS COLLEGE OF MED (CHI/PEOR/ROCK/CHM-URB)
Graduated: 1994
NPI: 1013022482
Practice Locations (1)
PRISMA HEALTH MEDICAL GROUP-MIDLANDS
14 RICHLAND MEDICAL PARK DR, SUITE 350
COLUMBIA, SC 292036896
8034341663
Source: CMS National Downloadable File, September 2026.