Medical school: UNIVERSITY OF SOUTH CAROLINA SCHOOL OF MEDICINE
Graduated: 2008
NPI: 1639601594
Practice Locations (2)
LIFESOURCE OF NORTH CAROLINA
3205 RANDALL PKWY, SUITE 105
WILMINGTON, NC 284032565
9107429243
LIFESOURCE OF NORTH CAROLINA
939 SPRINGDALE DR
CLINTON, SC 293257266
9107429243
Source: CMS National Downloadable File, September 2026.