Medical school: UNIVERSITY OF TEXAS SOUTHWESTERN MEDICAL SCHOOL AT DALLAS
Graduated: 1992
NPI: 1225027907
Practice Locations (2)
1000 W NIFONG BLVD BLDG 3, SUITE 100
COLUMBIA, MO 652035609
1000 W NIFONG BUILDING 3, SUITE 100
COLUMBIA, MO 65203
Source: CMS National Downloadable File, September 2026.