Medical school: UNIVERSITY OF KANSAS SCHOOL OF MED (KC/WICH/SAL)
Graduated: 1990
NPI: 1063572493
Practice Locations (1)
PRIME HEALTHCARE PHYSICIAN SERVICES - PROVIDENCE INC
8101 PARALLEL PKWY, SUITE 100
KANSAS CITY, KS 661122067
9132999200
Source: CMS National Downloadable File, September 2026.