Medical school: UNIVERSITY OF ILLINOIS COLLEGE OF MED (CHI/PEOR/ROCK/CHM-URB)
Graduated: 1997
NPI: 1417046871
Practice Locations (2)
THE SOUTHEAST PERMANENTE MEDICAL GROUP
3495 PIEDMONT RD NE
ATLANTA, GA 303051729
4043647206
THE SOUTHEAST PERMANENTE MEDICAL GROUP
8011 MALL PKWY
LITHONIA, GA 300382543
7705279031
Source: CMS National Downloadable File, September 2026.