Medical school: UNIVERSITY OF SOUTH CAROLINA SCHOOL OF MEDICINE
Graduated: 1994
NPI: 1114935483
Practice Locations (1)
PROVIDENCE HEALTH ALLIANCE
601 W STATE HWY 6 101, WACO CENTER FOR WOMENS HEALTH
WACO, TX 767105592
2547725454
Source: CMS National Downloadable File, September 2026.