Medical school: UNIVERSITY OF KANSAS SCHOOL OF MED (KC/WICH/SAL)
Graduated: 2019
NPI: 1447710546
Practice Locations (1)
PRIME HEALTHCARE PHYSICIAN SERVICES - PROVIDENCE INC
8929 PARALLEL PKWY
KANSAS CITY, KS 661121689
9135964000
Source: CMS National Downloadable File, September 2026.