Medical school: WAYNE STATE UNIVERSITY SCHOOL OF MEDICINE
Graduated: 2004
NPI: 1588874978
Practice Locations (3)
PO BOX, SUITE 255228
Sacramento, CA 958655228
PO BOX, SUITE 255228
SACRAMENTO, CA 95865
777 LOWNDES HILL RD, BLDG 1
GREENVILLE, SC 296072131
Source: CMS National Downloadable File, September 2026.