Medical school: UNIVERSITY OF TEXAS MEDICAL SCHOOL AT HOUSTON
Graduated: 2004
NPI: 1265424907
Practice Locations (2)
2800 CANNONS LN, SUITE 200
LOUISVILLE, KY 402052164
KENTUCKIANA ORAL AND MAXILLOFACIAL SURGERY ASSOC PSC
2800 CANNONS LN, SUITE 200
LOUISVILLE, KY 402052173
5024544885
Source: CMS National Downloadable File, September 2026.