Medical school: MEDICAL UNIVERSITY OF SOUTH CAROLINA COLLEGE OF MEDICINE
Graduated: 2002
Offers telehealth
NPI: 1013033273
Practice Locations (1)
SOUTH CAROLINA DEPT OF MENTAL HEALTH ACCOUNTING OFFICE
2715 COLONIAL DR
COLUMBIA, SC 292036818
8038980123
Source: CMS National Downloadable File, September 2026.