Medical school: LOUISIANA STATE UNIVERSITY SCHOOL OF MEDICINE IN SHREVEPORT
Graduated: 1984
NPI: 1093829392
Practice Locations (1)
LSU HEALTH SCIENCES CENTER SHREVEPORT FACULTY GROUP PRACTICE
1606 KINGS HWY
SHREVEPORT, LA 711034128
3186756402
Source: CMS National Downloadable File, September 2026.