Medical school: LOUISIANA STATE UNIVERSITY SCHOOL OF MEDICINE IN SHREVEPORT
Graduated: 2001
NPI: 1245255579
Practice Locations (1)
LSU HEALTH SCIENCES CENTER SHREVEPORT FACULTY GROUP PRACTICE
1541 KINGS HWY
SHREVEPORT, LA 711034228
3186755000
Source: CMS National Downloadable File, September 2026.