Medical school: CLVLND CLINIC LERNER COLLEGE OF MED OF CASE WSTN RSV UNIVERSITY
Graduated: 1997
NPI: 1629020037
Practice Locations (1)
EAU CLAIRE COOPERATIVE HEALTH CENTER, INC.
4605 MONTICELLO RD
COLUMBIA, SC 292034156
8037140266
Source: CMS National Downloadable File, September 2026.