Medical school: UNIVERSITY OF SOUTH CAROLINA SCHOOL OF MEDICINE
Graduated: 2015
NPI: 1568840940
Practice Locations (3)
240 E SHORE RD, APT 447
GREAT NECK, NY 110232448
761 MIDDLE COUNTRY RD
SELDEN, NY 117842502
PO BOX, SUITE 1173
SALEM, UT 84653
Source: CMS National Downloadable File, September 2026.