Medical school: MEDICAL COLLEGE OF WISCONSIN
Graduated: 1992
NPI: 1639285083
Practice Locations (2)
SELF MEDICAL GROUP
1325 SPRING ST
GREENWOOD, SC 296463860
8647254111
SELF MEDICAL GROUP
160 ACADEMY AVE
GREENWOOD, SC 296463808
8642238090
Source: CMS National Downloadable File, September 2026.