Medical school: CLVLND CLINIC LERNER COLLEGE OF MED OF CASE WSTN RSV UNIVERSITY
Graduated: 2000
NPI: 1417125535
Practice Locations (1)
STATE OF MISSISSIPPI - UNIVERSITY OF MISSISSIPPI MEDICAL CENTER
2500 N STATE ST
JACKSON, MS 392164500
6018984404
Source: CMS National Downloadable File, September 2026.