Medical school: UNIVERSITY OF KANSAS SCHOOL OF MED (KC/WICH/SAL)
Graduated: 2014
NPI: 1326466012
Practice Locations (1)
PRIME HEALTHCARE PHYSICIAN SERVICES - PROVIDENCE INC
8940 STATE AVE
KANSAS CITY, KS 661121646
9135961313
Source: CMS National Downloadable File, September 2026.