Medical school: LOUISIANA STATE UNIVERSITY SCHOOL OF MEDICINE IN SHREVEPORT
Graduated: 1998
NPI: 1508884693
Practice Locations (1)
FLORIDA PARISHES HUMAN SERVICES AUTHORITY
1951 FLORIDA AVE SW, SUITES DANDE
DENHAM SPRINGS, LA 707264970
2256650473
Source: CMS National Downloadable File, September 2026.