Medical school: KANSAS CITY MEDICAL COLLEGE
Graduated: 2004
NPI: 1205989084
Practice Locations (2)
PHELPS COUNTY REGIONAL MEDICAL CENTER
1000 W 10TH ST
ROLLA, MO 654012905
5734588899
PHELPS COUNTY REGIONAL MEDICAL CENTER
1000 W 10TH ST, PHELPS HEALTH
ROLLA, MO 654012905
5734588899
Source: CMS National Downloadable File, September 2026.