Medical school: UNIVERSITY OF KENTUCKY COLLEGE OF MEDICINE
Graduated: 1996
Also: ADDICTION MEDICINE
NPI: 1609873868
Practice Locations (1)
CONVIVA MEDICAL CENTER MANAGEMENT, LLC
463646 STATE RD, 200 SUITE 12
YULEE, FL 320970303
9047753601
Source: CMS National Downloadable File, September 2026.