Graduated: 1986
NPI: 1568603041
Practice Locations (3)
9400 WILLIAMSBURG PLAZA, SUITE 100
LOUISVILLE, KY 402225097
12803 RIDGE LOCK COURT
PROSPECT, KY 40059
12803 RIDGE LOCK CT
PROSPECT, KY 400599171
Source: CMS National Downloadable File, September 2026.