Medical school: RUSH MEDICAL COLLEGE OF RUSH UNIVERSITY
Graduated: 2004
Offers telehealth
NPI: 1568580744
Practice Locations (1)
NORTHSIDE PRIMARY CARE PROFESSIONAL SERVICES,LLC
960 JOHNSON FERRY RD, SUITE 500
ATLANTA, GA 303421630
4042570006
Source: CMS National Downloadable File, September 2026.