Medical school: LOUISIANA STATE UNIVERSITY SCHOOL OF MEDICINE IN SHREVEPORT
Graduated: 1984
Also: INTERNAL MEDICINE
NPI: 1205876307
Practice Locations (1)
NEW YORK SOCIETY FOR THE RELIEF OF RUPTURED AND CRIPPLED MAINTAINING
535 E 70TH ST
NEW YORK, NY 100214823
2127747598
Source: CMS National Downloadable File, September 2026.