Medical school: MEDICAL COLLEGE OF GEORGIA SCHOOL OF MEDICINE
Graduated: 2023
NPI: 1023707460
Practice Locations (3)
4500 SAN PABLO RD S
JACKSONVILLE, FL 322241865
PO BOX
MINNEAPOLIS, MN 55486
200 1ST ST SW
ROCHESTER, MN 559050001
Source: CMS National Downloadable File, September 2026.