Medical school: UNIVERSITY OF KANSAS SCHOOL OF MED (KC/WICH/SAL)
Graduated: 1995
NPI: 1104892348
Practice Locations (1)
INTEGRATED REGIONAL LABORATORIES PATHOLOGY SERVICES, LLC
21298 OLEAN BLVD
PORT CHARLOTTE, FL 339526705
9416276128
Source: CMS National Downloadable File, September 2026.