Medical school: MEDICAL COLLEGE OF GEORGIA SCHOOL OF MEDICINE
Graduated: 1979
NPI: 1386692812
Practice Locations (2)
500 MEDICAL CTR BLVD, SUITE 300
Lawrenceville, GA 300463332
500 MEDICAL CTR BLVD, SUITE 300
LAWRENCEVILLE, GA 300463332
7709631340
Source: CMS National Downloadable File, September 2026.