Medical school: SOUTHERN ILLINOIS UNIV SCHOOL OF DENTAL MEDICINE
Graduated: 2024
NPI: 1154194041
Practice Locations (2)
1002 N CHURCH ST, SUITE 203
GREENSBORO, NC 274011439
3030 NW EXPRESSWAY, SUITE 1000
Oklahoma City, OK 731124019
Source: CMS National Downloadable File, September 2026.