Medical school: UNIVERSITY OF SOUTH CAROLINA SCHOOL OF MEDICINE
Graduated: 2003
NPI: 1619155793
Practice Locations (3)
17401 69TH AVE
FRESH MEADOWS, NY 113653404
573 ASBURY NEELY WAY
Roebuck, SC 293763354
818 E MAIN ST, SUITE A
SPARTANBURG, SC 293022000
Source: CMS National Downloadable File, September 2026.