Medical school: JC EDWARDS SCHOOL OF MEDICINE, MARSHALL UNIVERSITY
Graduated: 1997
NPI: 1578526943
Practice Locations (2)
538 3RD AVE
CHARLESTON, WV 253031328
538 3RD AVE
SOUTH CHARLESTON, WV 253031328
3043629883
Source: CMS National Downloadable File, September 2026.