Medical school: UNIVERSITY OF SOUTHERN CALIFORNIA KECK SCHOOL OF MEDICINE
Graduated: 1995
NPI: 1104913912
Practice Locations (1)
LSU HEALTH SCIENCES CENTER SHREVEPORT FACULTY GROUP PRACTICE
1541 KINGS HWY
SHREVEPORT, LA 711034228
3186755000
Source: CMS National Downloadable File, September 2026.