Medical school: UNIVERSITY OF MISSOURI, KANSAS CITY, SCHOOL OF MEDICINE
Graduated: 1981
Offers telehealth
NPI: 1164458865
Practice Locations (1)
CONVIVA MEDICAL CENTER MANAGEMENT, LLC
20 BLANDING BLVD
ORANGE PARK, FL 320732235
9047738977
Source: CMS National Downloadable File, September 2026.