Medical school: LOUISIANA STATE UNIVERSITY SCHOOL OF MEDICINE IN SHREVEPORT
Graduated: 2023
NPI: 1568166270
Practice Locations (2)
1643 NW 136TH AVE
Sunrise, FL 333232857
1643 NW 136 AVE
SUNRISE, FL 333232857
Source: CMS National Downloadable File, September 2026.