Medical school: UNIVERSITY OF SOUTHERN CALIFORNIA KECK SCHOOL OF MEDICINE
Graduated: 1998
NPI: 1528003787
Practice Locations (2)
CEP AMERICA LLC
1 BUBBA WATSON DR, VITUITY
PENSACOLA, FL 32504
8504167000
ICH ER SERVICES LLC
800 N FANT ST
ANDERSON, SC 296215708
8645121000
Source: CMS National Downloadable File, September 2026.