Medical school: KENT STATE UNIVERSITY COLLEGE OF PODIATRIC MEDICINE
Graduated: 1986
NPI: 1659361442
Practice Locations (2)
1705 CHRISTY DR, SUITE 100
JEFFERSON CITY, MO 651015195
5736357022
SSM REGIONAL HEALTH SERVICES
2505 MISSION DR
JEFFERSON CITY, MO 651099508
Source: CMS National Downloadable File, September 2026.