Medical school: EAST TENNESSEE STATE UNIVERSITY QUILLEN COLLEGE OF MEDICINE
Graduated: 2020
NPI: 1396368197
Practice Locations (2)
1001 NOBLE ST, SUITE 460
Fairbanks, AK 997014948
PO BOX, SUITE 73720
FAIRBANKS, AK 99707
Source: CMS National Downloadable File, September 2026.