Medical school: SOUTHERN ILLINOIS UNIVERSITY SCHOOL OF MEDICINE
Graduated: 2020
NPI: 1265092381
Practice Locations (4)
PO, 1518 ATTN GOVERNMENT PAYER ENROLLMENT
Pasadena, CA 911101518
777 LAWNDRES HILL RD
GREENVILLE, SC 296072101
777 LOWNDES HILL RD, BLDG 1
GREENVILLE, SC 296072131
12040 NE 128TH ST, MS 50
KIRKLAND, WA 980343013
Source: CMS National Downloadable File, September 2026.