Medical school: MEDICAL UNIVERSITY OF SOUTH CAROLINA COLLEGE OF MEDICINE
Graduated: 1991
NPI: 1508823444
Practice Locations (2)
3634 SUNSET BLVD
WEST COLUMBIA, SC 291693052
8039260969
3634 SUNSET BLVD, SUITE B
WEST COLUMBIA, SC 291693052
Source: CMS National Downloadable File, September 2026.