Medical school: MEDICAL COLLEGE OF GEORGIA SCHOOL OF MEDICINE
Graduated: 2023
NPI: 1508542556
Practice Locations (3)
PO BOX, SUITE 670747
Marietta, GA 300660130
3360 BRIDLE RUN TRL NW
MARIETTA, GA 300641788
PO BOX, SUITE 670747
MARIETTA, GA 30066
Source: CMS National Downloadable File, September 2026.