Medical school: UNIVERSITY OF NEBRASKA COLLEGE OF MEDICINE
Graduated: 2001
NPI: 1083880850
Practice Locations (3)
1643 NW 136 AVE
SUNRISE, FL 333232857
3 RICHLAND MEDICAL PARK DR, SUITE 310
Columbia, SC 292036862
PO BOX, SUITE 421718
GEORGETOWN, SC 29442
Source: CMS National Downloadable File, September 2026.