Medical school: UNIVERSITY OF OKLAHOMA COLLEGE OF MEDICINE
Graduated: 2011
Offers telehealth
NPI: 1356502959
Practice Locations (1)
NORTHSIDE SURGICAL PROFESSIONAL SERVICES LLC
960 JOHNSON FY RD NE, SUITE 130
ATLANTA, GA 303421601
4043002990
Source: CMS National Downloadable File, September 2026.