Medical school: UNIVERSITY OF KANSAS SCHOOL OF MED (KC/WICH/SAL)
Graduated: 2005
NPI: 1366593915
Practice Locations (1)
PRIME HEALTHCARE PHYSICIAN SERVICES - PROVIDENCE INC
1420 S 42ND ST, PMG ARGENTINE
KANSAS CITY, KS 661061952
9138311100
Source: CMS National Downloadable File, September 2026.